Provider Demographics
NPI:1720068885
Name:HILLSBOROUGH EMERGENCY MEDICAL SERVICES CORP
Entity Type:Organization
Organization Name:HILLSBOROUGH EMERGENCY MEDICAL SERVICES CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EMS COORDINATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:GWIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-369-0662
Mailing Address - Street 1:PO BOX 207
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18105-0207
Mailing Address - Country:US
Mailing Address - Phone:484-664-2007
Mailing Address - Fax:484-664-2015
Practice Address - Street 1:48 EAST MOUNTAIN ROAD
Practice Address - Street 2:
Practice Address - City:NESHANIC
Practice Address - State:NJ
Practice Address - Zip Code:08853
Practice Address - Country:US
Practice Address - Phone:908-369-0662
Practice Address - Fax:908-369-7930
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-17
Last Update Date:2012-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJHEMS002593416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3373304Medicaid
NJ3373304Medicaid