Organization
TOWNSHIP OF PENNSAUKEN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIKE COYLE (CHIEF)
(856) 665-2323
Entity
Organization
Contact information
Practice address
5605 N CRESCENT BLVD, PENNSAUKEN, NJ 08110-1834
(856) 665-2323
Mailing address
5605 N CRESCENT BLVD, PENNSAUKEN, NJ 08110-1834
(856) 665-2323
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
PENN00652
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0538633
AETNA
NJ
01
—
0841172000
AMERIHEALTH
NJ
01
—
1023168
HORIZON NJ HEALTH
NJ
01
—
53486
AMERIGROUP
NJ
01
—
590010122
RAILROAD MEDICARE
NJ
05
—
6700608
—
NJ
01
—
91000025700
AMERICHOICE
NJ
Enumeration date
03/07/2007
Last updated
06/20/2008
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