Provider Demographics
NPI:1770686321
Name:CITY OF PASSAIC
Entity Type:Organization
Organization Name:CITY OF PASSAIC
Other - Org Name:PASSAIC EMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:LIEUTENANT
Authorized Official - Prefix:
Authorized Official - First Name:EDWIN
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMIREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-365-5774
Mailing Address - Street 1:54 GROVE ST
Mailing Address - Street 2:
Mailing Address - City:PASSAIC
Mailing Address - State:NJ
Mailing Address - Zip Code:07055-5002
Mailing Address - Country:US
Mailing Address - Phone:973-365-5774
Mailing Address - Fax:
Practice Address - Street 1:54 GROVE ST
Practice Address - Street 2:
Practice Address - City:PASSAIC
Practice Address - State:NJ
Practice Address - Zip Code:07055-5002
Practice Address - Country:US
Practice Address - Phone:973-365-5774
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-07
Last Update Date:2010-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJPASS004443416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7172001Medicaid
NJ293224Medicare ID - Type Unspecified