Provider Demographics
NPI:1609822246
Name:MILLVILLE RESCUE SQUAD
Entity type:Organization
Organization Name:MILLVILLE RESCUE SQUAD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:REDDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-825-5063
Mailing Address - Street 1:PO BOX 576
Mailing Address - Street 2:
Mailing Address - City:MILLVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08332-0576
Mailing Address - Country:US
Mailing Address - Phone:856-825-5063
Mailing Address - Fax:856-825-4713
Practice Address - Street 1:600 CEDAR ST
Practice Address - Street 2:
Practice Address - City:MILLVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08332-9415
Practice Address - Country:US
Practice Address - Phone:856-825-5063
Practice Address - Fax:856-825-4713
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-25
Last Update Date:2009-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMILL00381341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ22466OtherAMERICAID
NJNJ5848OtherHEALTHNET
NJ1038939OtherHORIZON NJ HEALTH
NJ590010118OtherUNITED HEALTH CARE/ MCR
NJ239411OtherAMERIHEALTH
0547429OtherAETNA USHC
NJ6915906Medicaid
NJA0567038OtherOXFORD
NJ590010118OtherUNITED HEALTH CARE/ MCR