Provider Demographics
NPI:1336487461
Name:MEDFORCE AMBULANCE MEDICAL SERVICES
Entity Type:Organization
Organization Name:MEDFORCE AMBULANCE MEDICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:DIAZ
Authorized Official - Suffix:
Authorized Official - Credentials:EMT
Authorized Official - Phone:201-275-7310
Mailing Address - Street 1:60 E BARBOUR ST
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:HALEDON
Mailing Address - State:NJ
Mailing Address - Zip Code:07508-1546
Mailing Address - Country:US
Mailing Address - Phone:201-275-7310
Mailing Address - Fax:
Practice Address - Street 1:60 E BARBOUR ST
Practice Address - Street 2:1ST FLOOR
Practice Address - City:HALEDON
Practice Address - State:NJ
Practice Address - Zip Code:07508-1546
Practice Address - Country:US
Practice Address - Phone:201-275-7310
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-24
Last Update Date:2013-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ100569341600000X, 3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
No3416L0300XTransportation ServicesAmbulanceLand Transport