Provider Demographics
NPI:1649474586
Name:UPPER TOWNSHIP
Entity type:Organization
Organization Name:UPPER TOWNSHIP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:JAY
Authorized Official - Middle Name:D
Authorized Official - Last Name:POTTER
Authorized Official - Suffix:
Authorized Official - Credentials:NREMT
Authorized Official - Phone:609-628-2486
Mailing Address - Street 1:2100 ROUTE 631
Mailing Address - Street 2:
Mailing Address - City:WOODBINE
Mailing Address - State:NJ
Mailing Address - Zip Code:08270
Mailing Address - Country:US
Mailing Address - Phone:609-628-2486
Mailing Address - Fax:609-628-4610
Practice Address - Street 1:2028 ROUTE 631
Practice Address - Street 2:
Practice Address - City:WOODBINE
Practice Address - State:NJ
Practice Address - Zip Code:08270-9630
Practice Address - Country:US
Practice Address - Phone:609-628-2486
Practice Address - Fax:609-628-4610
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-13
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJU0511013341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance