Provider Demographics
NPI:1417088436
Name:WASHINGTON TOWNSHIP AMBULANCE ASSOCIATION
Entity type:Organization
Organization Name:WASHINGTON TOWNSHIP AMBULANCE ASSOCIATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:GM
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:A
Authorized Official - Last Name:FOWLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-228-5995
Mailing Address - Street 1:PO BOX 1016
Mailing Address - Street 2:
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-7016
Mailing Address - Country:US
Mailing Address - Phone:856-784-3715
Mailing Address - Fax:
Practice Address - Street 1:4 WILLOW ST
Practice Address - Street 2:
Practice Address - City:TURNERSVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08012-1647
Practice Address - Country:US
Practice Address - Phone:856-232-6151
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2012-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJWASH00626341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ116320500OtherDEPT OF LABOR
NJ91000324400OtherAMERICHOICE
NJ0712649000OtherAMERIHEALTH
NJ590013044OtherRAILROAD MEDICARE
NJ1087133OtherHORIZON NJ HEALTH
NJ0712649000OtherKEYSTONE
NJ2065390OtherAETNA
NJ33172OtherHEALTH PARTNERS
NJ0075673210002OtherPENNSYLVANIA MEDICAID
NJ7769709Medicaid
NJ7769709Medicaid