Provider Demographics
NPI:1669463402
Name:FAIRFIELD TOWNSHIP
Entity Type:Organization
Organization Name:FAIRFIELD TOWNSHIP
Other - Org Name:FAIRFIELD TWP AMB SRVC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:BATEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-451-3676
Mailing Address - Street 1:PO BOX 66
Mailing Address - Street 2:
Mailing Address - City:BRIDGETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08320-0066
Mailing Address - Country:US
Mailing Address - Phone:800-473-2278
Mailing Address - Fax:
Practice Address - Street 1:43 MAIN STREET
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:NJ
Practice Address - Zip Code:08320
Practice Address - Country:US
Practice Address - Phone:856-451-3676
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-01
Last Update Date:2014-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
0X00200379OtherACS HEALTH NET COMMERCIAL
NJ5113903Medicaid
1079100OtherKEYSTONE MERCY HMO DPA
0X00200379OtherPHS HEALTHPLAN COMMERCIAL
91000397400OtherAMERICHOICE OF NJ INC
91000397400OtherAMERICAN CHOICE
0120129OtherAETNA USHC BLUE BELL HMO
0X00200379OtherACS HEALTH NET HMO MDC
0X00200379OtherPHS HEALTH PLAN HMO MDC
0X00200379OtherQUALMED
0000201470Medicare ID - Type UnspecifiedHGSA
NJ5113903Medicaid