Provider Demographics
NPI:1811013873
Name:TOWNSHIP OF WESTAMPTON
Entity Type:Organization
Organization Name:TOWNSHIP OF WESTAMPTON
Other - Org Name:WESTAMPTON TOWNSHIP EMERGENCY SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:WYLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-784-3715
Mailing Address - Street 1:PO BOX 467
Mailing Address - Street 2:
Mailing Address - City:LUMBERTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08048
Mailing Address - Country:US
Mailing Address - Phone:609-261-1002
Mailing Address - Fax:609-261-6088
Practice Address - Street 1:710 RANCOCAS ROAD
Practice Address - Street 2:
Practice Address - City:WESTAMPTON
Practice Address - State:NJ
Practice Address - Zip Code:08060-5642
Practice Address - Country:US
Practice Address - Phone:609-267-2041
Practice Address - Fax:609-267-7398
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TOWNSHIP OF WESTAMPTON
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-03-21
Last Update Date:2010-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJWEST00650341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0099872Medicaid
NJ1118670OtherHORIZON NJ HEALTH
NJ0058256000OtherAMERIHEALTH
NJ0058256000OtherKEYSTONE
NJ910000096800OtherAMERICHOICE
NJ2234343OtherAETNA
NJ0099872Medicaid