Basic Information
| Provider Information | |||||||||
| NPI: | 1770817637 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HACKETTSTOWN REGIONAL MEDICAL CENTER EMERGENCY MEDICAL SERVICES, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 651 WILLOW GROVE ST | ||||||||
| Address2: | |||||||||
| City: | HACKETTSTOWN | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 078401799 | ||||||||
| CountryCode: | US | ||||||||
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| Address1: | 651 WILLOW GROVE ST | ||||||||
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| City: | HACKETTSTOWN | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 078401799 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9088525100 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/25/2009 | ||||||||
| LastUpdateDate: | 01/07/2013 | ||||||||
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| AuthorizedOfficialLastName: | COE | ||||||||
| AuthorizedOfficialFirstName: | JASON | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT/CEO | ||||||||
| AuthorizedOfficialTelephone: | 9088506802 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | GENERAL CONFERENCE OF SEVENTH DAY ADVENTIST HACKETTSTOWN COMMUNITY HOS | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 3416L0300X | H2112018 | NJ | Y | Transportation Services | Ambulance | Land Transport |
No ID Information.