Mobile Life Support Services . Inc

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

M1212061 Issued in NJ

Legal business name

MOBILE LIFE SUPPORT SERVICES . INC

Practice address

540 Bordentown Ave
Ste 4a
South Amboy, NJ 08879-1546

Phone

(732) 952-8755

Fax

(732) 952-8754

NPI assigned

Jun 4, 2007

Last updated

May 27, 2014By 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

Miss Nataliya Magaga

Title

Office Manager

Phone

(732) 952-8755

Specialties & licenses 1

Addresses

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": "1180915200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1401148800000",
    "number": "1932301785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "540 BORDENTOWN AVE",
            "address_2": "STE 4A",
            "city": "SOUTH AMBOY",
            "state": "NJ",
            "postal_code": "088791546",
            "telephone_number": "732-952-8755",
            "fax_number": "732-952-8754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 BORDENTOWN AVE",
            "address_2": "STE 4A",
            "city": "SOUTH AMBOY",
            "state": "NJ",
            "postal_code": "088791546",
            "telephone_number": "732-952-8755",
            "fax_number": "732-952-8754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOBILE LIFE SUPPORT SERVICES . INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-04",
        "last_updated": "2014-05-27",
        "status": "A",
        "authorized_official_last_name": "MAGAGA",
        "authorized_official_first_name": "NATALIYA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "732-952-8755",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "NJ",
            "license": "M1212061",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Land Ambulance in South Amboy, NJ
• Providers in South Amboy, 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 May 27, 2014; 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.