Provider Demographics
NPI:1700510641
Name:STATE-WIDE NON-EMERGENCY TRANS
Entity Type:Organization
Organization Name:STATE-WIDE NON-EMERGENCY TRANS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:HERMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-227-5068
Mailing Address - Street 1:1371 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07060-2937
Mailing Address - Country:US
Mailing Address - Phone:908-205-0859
Mailing Address - Fax:732-627-0991
Practice Address - Street 1:1371 PARK AVE
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07060-2937
Practice Address - Country:US
Practice Address - Phone:908-205-0859
Practice Address - Fax:732-627-0991
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-15
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)