Provider Demographics
NPI:1679103493
Name:JERSEY MEDICAL TRANSPORTATION LLC
Entity Type:Organization
Organization Name:JERSEY MEDICAL TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CHERVIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-957-0755
Mailing Address - Street 1:335 NEW RD STE 13
Mailing Address - Street 2:
Mailing Address - City:MONMOUTH JUNCTION
Mailing Address - State:NJ
Mailing Address - Zip Code:08852-2432
Mailing Address - Country:US
Mailing Address - Phone:732-412-9290
Mailing Address - Fax:
Practice Address - Street 1:335 NEW RD STE 13
Practice Address - Street 2:
Practice Address - City:MONMOUTH JUNCTION
Practice Address - State:NJ
Practice Address - Zip Code:08852-2432
Practice Address - Country:US
Practice Address - Phone:732-412-9290
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-21
Last Update Date:2020-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)