# WOODBURY TLC TRANSPORT, INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1063469153
- **Authorized official:** MR. JOEL DAVIDS (CFO)
- **Authorized official phone:** (856) 848-1146

## Contact information

- **Practice address:** 575 WOODBURY GLASSBORO RD, SEWELL, NJ 08080-4563
- **Practice address phone:** (856) 256-1390
- **Practice address fax:** (856) 256-0656
- **Mailing address:** 575 WOODBURY GLASSBORO RD, SEWELL, NJ 08080-4563
- **Mailing address phone:** (856) 256-1390
- **Mailing address fax:** (856) 256-0656

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 341600000X | Ambulance | — | NJ | Yes |

## Other

- **Enumeration date:** 05/27/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0000129000 | IBC GROUP | NJ |
| 01 | — | 1004473 | HORIZON NJ HEALTH | NJ |
| 05 | — | 3295907 | — | NJ |
| 01 | — | 35615 | AETNA | NJ |
| 01 | — | 57259 | AMERIGROUP | NJ |
| 01 | — | J13285 | HEALTHNET | NJ |