Provider Demographics
NPI:1760829840
Name:EDDIE G OCAMPO
Entity Type:Organization
Organization Name:EDDIE G OCAMPO
Other - Org Name:BONA LIFE AMBULANCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SUMEER
Authorized Official - Middle Name:
Authorized Official - Last Name:TOTEJA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-803-1210
Mailing Address - Street 1:28 CHURCH ST UNIT 6
Mailing Address - Street 2:
Mailing Address - City:LODI
Mailing Address - State:NJ
Mailing Address - Zip Code:07644-2437
Mailing Address - Country:US
Mailing Address - Phone:201-281-7610
Mailing Address - Fax:732-283-4020
Practice Address - Street 1:28 CHURCH ST UNIT 6
Practice Address - Street 2:
Practice Address - City:LODI
Practice Address - State:NJ
Practice Address - Zip Code:07644-2437
Practice Address - Country:US
Practice Address - Phone:201-281-7610
Practice Address - Fax:732-283-4020
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-29
Last Update Date:2013-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ02120933416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport