Borough of Roselle
Organization Active NPI Land Ambulance · Roselle, NJ
NPI 1477532695 · NPPES record last updated Apr 27, 2011
Key facts
- NPI
- 1477532695
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Land Ambulance 3416L0300X
- License
- ROSE00505 (NJ)
- Legal business name
- BOROUGH OF ROSELLE
- Practice address
- 725 Chestnut Street
Roselle, NJ 07203 - Phone
- (908) 245-8600
- Fax
- (908) 245-7260
- NPI assigned
- Jan 16, 2006
- Organization subpart
- No
Authorized official
- Name
- Paul S. Mucha
- Title
- Fire Chief
- Phone
- (908) 245-8600
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NJ
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20090508000254 | NJ | Part B Supplier - Ambulance Service Supplier | 9234025016 | Practice locations: Roselle, NJ |
National Provider Directory
Locations
210 Chestnut St
Fl 2
Roselle, NJ 07203
Phone (908) 245-3031
725 Chestnut St
Roselle, NJ 07203
Phone (908) 245-8600
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | ROSE00505 | NJ | Yes |
Addresses
Primary practice location
725 Chestnut Street
Roselle, NJ 07203
Mailing address
PO Box 207
Allentown, PA 18105-0207
Phone (484) 664-2007
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7131607 | Medicaid | NJ |
Other names
- Roselle Fire Department
Other providers in Roselle, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 27, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.