Provider Demographics
NPI:1497205801
Name:OLD BRIDGE FIRST AID AND RESCUE SQUAD OF MADISON TOWNSHIP INC
Entity Type:Organization
Organization Name:OLD BRIDGE FIRST AID AND RESCUE SQUAD OF MADISON TOWNSHIP INC
Other - Org Name:OLD BRIDGE FIRST AID AND RESCUE SQUAD
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:GREGOIRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:848-228-0887
Mailing Address - Street 1:200 MARLBORO RD
Mailing Address - Street 2:
Mailing Address - City:OLD BRIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:08857-1425
Mailing Address - Country:US
Mailing Address - Phone:732-238-6686
Mailing Address - Fax:
Practice Address - Street 1:200 MARLBORO RD
Practice Address - Street 2:
Practice Address - City:OLD BRIDGE
Practice Address - State:NJ
Practice Address - Zip Code:08857-1425
Practice Address - Country:US
Practice Address - Phone:732-238-6686
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-10
Last Update Date:2017-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ12110363416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport