Provider Demographics
NPI:1598054611
Name:NJ RAPID CARE AMBULANCE LLC
Entity Type:Organization
Organization Name:NJ RAPID CARE AMBULANCE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELIJAH
Authorized Official - Middle Name:S
Authorized Official - Last Name:GRACE
Authorized Official - Suffix:
Authorized Official - Credentials:10/21/1988
Authorized Official - Phone:973-445-9560
Mailing Address - Street 1:1321 FAYETTE PL
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07060-3303
Mailing Address - Country:US
Mailing Address - Phone:973-445-9560
Mailing Address - Fax:973-707-7756
Practice Address - Street 1:1321 FAYETTE PL
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07060-3303
Practice Address - Country:US
Practice Address - Phone:973-445-9560
Practice Address - Fax:973-707-7756
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-29
Last Update Date:2011-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJN20120393416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport