Provider Demographics
NPI:1487669347
Name:BOROUGH OF RUNNEMEDE
Entity Type:Organization
Organization Name:BOROUGH OF RUNNEMEDE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MISCHICO
Authorized Official - Middle Name:
Authorized Official - Last Name:WARREN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-485-5267
Mailing Address - Street 1:24 N BLACK HORSE PIKE
Mailing Address - Street 2:P.O. BOX 267
Mailing Address - City:RUNNEMEDE
Mailing Address - State:NJ
Mailing Address - Zip Code:08078-1663
Mailing Address - Country:US
Mailing Address - Phone:856-939-5161
Mailing Address - Fax:
Practice Address - Street 1:24 N BLACK HORSE PIKE
Practice Address - Street 2:
Practice Address - City:RUNNEMEDE
Practice Address - State:NJ
Practice Address - Zip Code:08078-1663
Practice Address - Country:US
Practice Address - Phone:856-939-5161
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJRUNNE0073416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ072179Medicare PIN