Provider Demographics
NPI:1184978520
Name:SPARTA AMBULANCE SERVICE INC
Entity type:Organization
Organization Name:SPARTA AMBULANCE SERVICE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:D
Authorized Official - Last Name:SMETANA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-726-4040
Mailing Address - Street 1:14 SPARTA AVE
Mailing Address - Street 2:
Mailing Address - City:SPARTA
Mailing Address - State:NJ
Mailing Address - Zip Code:07871-1802
Mailing Address - Country:US
Mailing Address - Phone:973-726-4040
Mailing Address - Fax:973-726-4041
Practice Address - Street 1:14 SPARTA AVE
Practice Address - Street 2:
Practice Address - City:SPARTA
Practice Address - State:NJ
Practice Address - Zip Code:07871-1802
Practice Address - Country:US
Practice Address - Phone:973-726-4040
Practice Address - Fax:973-726-4041
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance