Provider Demographics
NPI:1144228461
Name:VIRGO MEDICAL SERVICES, INC
Entity Type:Organization
Organization Name:VIRGO MEDICAL SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:AHMED
Authorized Official - Middle Name:
Authorized Official - Last Name:HASSAN
Authorized Official - Suffix:
Authorized Official - Credentials:EMT
Authorized Official - Phone:973-676-7000
Mailing Address - Street 1:PO BOX 1067
Mailing Address - Street 2:
Mailing Address - City:EAST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07019-1067
Mailing Address - Country:US
Mailing Address - Phone:973-676-7000
Mailing Address - Fax:973-676-7002
Practice Address - Street 1:290 SANFORD ST
Practice Address - Street 2:
Practice Address - City:EAST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07018-1020
Practice Address - Country:US
Practice Address - Phone:973-676-7000
Practice Address - Fax:973-676-7002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1147015341600000X, 3416L0300X, 343800000X, 343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered341600000XTransportation ServicesAmbulance
Not Answered3416L0300XTransportation ServicesAmbulanceLand Transport
Not Answered343800000XTransportation ServicesSecured Medical Transport (VAN)
Not Answered343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
29937OtherUNIVERSITY HEALTH PLAN
7113152OtherAETNA INSURANCE
01000332500OtherAMERICHOICE
88348OtherAMERIGROUP
NJ1088266OtherNJ HORIZON HEALTH
1K7846OtherHEALTHNET
NJ7663301Medicaid
NJ7663301Medicaid
061896Medicare ID - Type Unspecified