Provider Demographics
NPI:1891823068
Name:TOWNSHIP OF MEDFORD
Entity Type:Organization
Organization Name:TOWNSHIP OF MEDFORD
Other - Org Name:MEDFORD EMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:BURGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-654-2608
Mailing Address - Street 1:17 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:08055-2411
Mailing Address - Country:US
Mailing Address - Phone:856-654-2608
Mailing Address - Fax:856-953-4087
Practice Address - Street 1:1 FIREHOUSE LN
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:NJ
Practice Address - Zip Code:08055-2726
Practice Address - Country:US
Practice Address - Phone:856-654-2608
Practice Address - Fax:856-953-4087
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-01
Last Update Date:2012-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1FDXE45P14HB388873416L0300X
NJ1FDKE30F1VHA304213416L0300X
NJ1FDXE45F6YHB731153416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7295308Medicaid
NJ7295308Medicaid
NJ590012663Medicare ID - Type UnspecifiedRAILROAD (BOX 24K)