South Branch Emergency Services Inc

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

CLIN00134 Issued in NJ

Legal business name

SOUTH BRANCH EMERGENCY SERVICES INC

Practice address

48 Old US Highway 22
Clinton, NJ 08809

Phone

(908) 735-4012

Fax

(908) 735-7125

NPI assigned

Jan 17, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Melinda Stortz

Title

President

Phone

(908) 735-4012

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1137456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604361600000",
    "number": "1295715357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 207",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181050207",
            "telephone_number": "484-664-2007",
            "fax_number": "484-664-2015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "48 OLD US HIGHWAY 22",
            "city": "CLINTON",
            "state": "NJ",
            "postal_code": "08809",
            "telephone_number": "908-735-4012",
            "fax_number": "908-735-7125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH BRANCH EMERGENCY SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-17",
        "last_updated": "2020-11-03",
        "certification_date": "2020-11-03",
        "status": "A",
        "authorized_official_last_name": "STORTZ",
        "authorized_official_first_name": "MELINDA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "908-735-4012",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "NJ",
            "license": "CLIN00134",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7218001",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• State of New Jersey Omb Centralized Payroll

• Land Ambulance in Clinton, NJ
• Providers in Clinton, NJ by specialty
• Land Ambulance in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.