Provider Demographics
NPI:1982736849
Name:TOWNSHIP OF LOGAN
Entity Type:Organization
Organization Name:TOWNSHIP OF LOGAN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:ANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:LOVELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-241-9100
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 1:125 MAIN ST
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:NJ
Practice Address - Zip Code:08014
Practice Address - Country:US
Practice Address - Phone:856-241-9100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJLOGA002341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0722897000OtherKEYSTONE
NJ2368093OtherAETNA
NJ8356602Medicaid
NJP00079795OtherRAILROAD MEDICARE
NJ91000095400OtherAMERICHOICE
NJ0722897000OtherAMERIHEALTH
NJ1126280OtherHORIZON NJ HEALTH
NJ0722897000OtherKEYSTONE