Provider Demographics
NPI:1497033617
Name:MONICA HERNANDEZ
Entity Type:Organization
Organization Name:MONICA HERNANDEZ
Other - Org Name:PRIMED AMBULANCE SERVICE, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-213-5667
Mailing Address - Street 1:701 FORD RD
Mailing Address - Street 2:#10
Mailing Address - City:ROCKAWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:07866-2053
Mailing Address - Country:US
Mailing Address - Phone:862-251-7078
Mailing Address - Fax:862-251-7079
Practice Address - Street 1:701 FORD RD
Practice Address - Street 2:#10
Practice Address - City:ROCKAWAY
Practice Address - State:NJ
Practice Address - Zip Code:07866-2053
Practice Address - Country:US
Practice Address - Phone:862-251-7078
Practice Address - Fax:862-251-7079
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-22
Last Update Date:2011-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJP1412051343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)