Provider Demographics
NPI: | 1013685106 |
---|---|
Name: | MRW MEDICAL TRANSPORTATION |
Entity type: | Organization |
Organization Name: | MRW MEDICAL TRANSPORTATION |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | OWNER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | MARTIN |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | WILLIS |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 856-839-5504 |
Mailing Address - Street 1: | 94 GREEN ST STE 202 |
Mailing Address - Street 2: | |
Mailing Address - City: | WOODBRIDGE |
Mailing Address - State: | NJ |
Mailing Address - Zip Code: | 07095-2947 |
Mailing Address - Country: | US |
Mailing Address - Phone: | |
Mailing Address - Fax: | |
Practice Address - Street 1: | 94 GREEN ST STE 202 |
Practice Address - Street 2: | |
Practice Address - City: | WOODBRIDGE |
Practice Address - State: | NJ |
Practice Address - Zip Code: | 07095-2947 |
Practice Address - Country: | US |
Practice Address - Phone: | 856-839-5504 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2021-09-02 |
Last Update Date: | 2025-04-21 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 343900000X | Transportation Services | Non-emergency Medical Transport (VAN) | ||
No | 146N00000X | Emergency Medical Service Providers | Emergency Medical Technician, Basic | Group - Single Specialty |