Organization
EN ROUTE MEDICAL TRANSPORT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TYRAN WHEATON (FIRST OFFICER)
(770) 294-4973
Entity
Organization
Contact information
Practice address
5453 GARFIELD AVE, PENNSAUKEN, NJ 08109-1129
(770) 294-4973
Mailing address
5453 GARFIELD AVE, PENNSAUKEN, NJ 08109-1129
(770) 294-4973
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
0400697199
NJ
Other
Enumeration date
12/02/2014
Last updated
12/02/2014
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