Provider Demographics
NPI:1023097268
Name:WHITEHOUSE FIRST AID & RESCUE SQUAD
Entity type:Organization
Organization Name:WHITEHOUSE FIRST AID & RESCUE SQUAD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:J
Authorized Official - Last Name:RAINEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-534-2509
Mailing Address - Street 1:PO BOX 175
Mailing Address - Street 2:
Mailing Address - City:WHITEHOUSE STATION
Mailing Address - State:NJ
Mailing Address - Zip Code:08889-0175
Mailing Address - Country:US
Mailing Address - Phone:908-534-2509
Mailing Address - Fax:908-534-2585
Practice Address - Street 1:269 MAIN ST
Practice Address - Street 2:
Practice Address - City:WHITEHOUSE STATION
Practice Address - State:NJ
Practice Address - Zip Code:08889-3620
Practice Address - Country:US
Practice Address - Phone:908-534-2509
Practice Address - Fax:908-534-2585
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-16
Last Update Date:2013-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJWHITE0283416L0300X, 341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
No3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8588201Medicaid
049190Medicare PIN