Magnolia Ambulance Corps Inc

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

MAGN00334 Issued in NJ

Legal business name

MAGNOLIA AMBULANCE CORPS INC

Doing business as

Magnolia Ambulance Corps

Practice address

112 S Warwick Rd
Magnolia, NJ 08049-1338

Phone

(856) 784-8089

Fax

(856) 784-1218

NPI assigned

May 14, 2007

Last updated

Feb 17, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Nick D'Amico

Title

President

Phone

(856) 784-8089

Specialties & licenses 1

Addresses

Other identifiers 6

Other names 1

• Magnolia Ambulance Corps Doing business as

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

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

{
    "created_epoch": "1179100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645056000000",
    "number": "1538374186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 S WARWICK RD",
            "city": "MAGNOLIA",
            "state": "NJ",
            "postal_code": "080491338",
            "telephone_number": "856-784-8089",
            "fax_number": "856-784-1218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 S WARWICK RD",
            "city": "MAGNOLIA",
            "state": "NJ",
            "postal_code": "080491338",
            "telephone_number": "856-784-8089",
            "fax_number": "856-784-1218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNOLIA AMBULANCE CORPS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-14",
        "last_updated": "2022-02-17",
        "certification_date": "2022-02-17",
        "status": "A",
        "authorized_official_last_name": "D'AMICO",
        "authorized_official_first_name": "NICK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "856-784-8089",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "NJ",
            "license": "MAGN00334",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "590012162",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0973007",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HORIZON MERCY",
            "identifier": "1063559",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH",
            "identifier": "0495584000",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "63457",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7480601",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Magnolia Ambulance Corps",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Magnolia Ambulance Corps",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• India Lark
• Chad Leonard, CSP
• Larrena Lewin, LMT,LPN
• Dayshawna Lowe
• Tiffani Lu, PHARM D
• Magnolia Public School
• Medical House Call Associates
• Alicia M Nordberg-Payne, PHARMD
• Assumpta Nosike
• Ihuoma J Ottih, APN-C

• Land Ambulance in Magnolia, NJ
• Providers in Magnolia, 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 Feb 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.