Basic Information
| Provider Information | |||||||||
| NPI: | 1720068885 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HILLSBOROUGH EMERGENCY MEDICAL SERVICES CORP | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 207 | ||||||||
| Address2: | |||||||||
| City: | ALLENTOWN | ||||||||
| State: | PA | ||||||||
| PostalCode: | 181050207 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4846642007 | ||||||||
| FaxNumber: | 4846642015 | ||||||||
| Practice Location | |||||||||
| Address1: | 48 EAST MOUNTAIN ROAD | ||||||||
| Address2: | |||||||||
| City: | NESHANIC | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 08853 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9083690662 | ||||||||
| FaxNumber: | 9083697930 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/17/2006 | ||||||||
| LastUpdateDate: | 12/21/2012 | ||||||||
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| AuthorizedOfficialLastName: | GWIN | ||||||||
| AuthorizedOfficialFirstName: | DAVID | ||||||||
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| AuthorizedOfficialTitleorPosition: | EMS COORDINATOR | ||||||||
| AuthorizedOfficialTelephone: | 9083690662 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 3416L0300X | HEMS00259 | NJ | Y | Transportation Services | Ambulance | Land Transport |
ID Information
| ID | Type | State | Issuer | Description | 3373304 | 05 | NJ | MEDICAID |