Provider Demographics
NPI:1811306541
Name:BELMAR RELIABLE TRANSPORTATION
Entity type:Organization
Organization Name:BELMAR RELIABLE TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:CLAUDE
Authorized Official - Last Name:LAVARIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-822-8767
Mailing Address - Street 1:706 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ASBURY PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07712-6520
Mailing Address - Country:US
Mailing Address - Phone:732-822-8767
Mailing Address - Fax:
Practice Address - Street 1:706 MAIN ST
Practice Address - Street 2:
Practice Address - City:ASBURY PARK
Practice Address - State:NJ
Practice Address - Zip Code:07712-6520
Practice Address - Country:US
Practice Address - Phone:732-822-8767
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-06
Last Update Date:2014-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ086726908077190343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ086726908077190OtherCORPORATION CODE