Provider Demographics
NPI:1427214915
Name:BEVERLY EMERGENCY SQUAD INC
Entity Type:Organization
Organization Name:BEVERLY EMERGENCY SQUAD INC
Other - Org Name:BEVERLY EDGEWATER PARK EMERGENCY SQUAD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:S
Authorized Official - Last Name:BALDINGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-386-7304
Mailing Address - Street 1:703 MELBOURNE AVE
Mailing Address - Street 2:
Mailing Address - City:BEVERLY
Mailing Address - State:NJ
Mailing Address - Zip Code:08010
Mailing Address - Country:US
Mailing Address - Phone:609-386-7304
Mailing Address - Fax:
Practice Address - Street 1:703 MELBOURNE AVE
Practice Address - Street 2:
Practice Address - City:BEVERLY
Practice Address - State:NJ
Practice Address - Zip Code:08010
Practice Address - Country:US
Practice Address - Phone:609-386-7304
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-04
Last Update Date:2008-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJB0311012341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance