Provider Demographics
NPI:1356661805
Name:THE LUMBERTON EMERGENCY SQUAD
Entity Type:Organization
Organization Name:THE LUMBERTON EMERGENCY SQUAD
Other - Org Name:LUMBERTON EMERGENCY SQUAD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:
Authorized Official - Last Name:WOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-261-1828
Mailing Address - Street 1:PO BOX 339
Mailing Address - Street 2:
Mailing Address - City:LUMBERTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08048-0339
Mailing Address - Country:US
Mailing Address - Phone:609-261-1828
Mailing Address - Fax:
Practice Address - Street 1:34 MUNICIPAL DR
Practice Address - Street 2:
Practice Address - City:LUMBERTON
Practice Address - State:NJ
Practice Address - Zip Code:08048-4556
Practice Address - Country:US
Practice Address - Phone:609-261-1828
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-07
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJL3110213416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0248193Medicaid