Organization
EVESHAM TOWNSHIP FIRE DISTRICT NO 1
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAUREEN MITCHELL (CEO)
(856) 983-2750
Entity
Organization
Contact information
Practice address
984 TUCKERTON RD, MARLTON, NJ 08053-2652
(856) 983-2750
Mailing address
984 TUCKERTON RD, EVESHAM, NJ 08053-2652
(856) 983-2750
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
EVES00198
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0056031
—
NJ
01
—
2335336000
AMERIHEALTH
NJ
01
—
60009823
HORIZON MERCY
NJ
01
—
91001542200
AMERICHOICE
NJ
Enumeration date
05/02/2007
Last updated
08/12/2020
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