1669515516 NPI number — TOWNSHIP OF EGG HARBOR

Table of content: (NPI 1669515516)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1669515516 NPI number — TOWNSHIP OF EGG HARBOR

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TOWNSHIP OF EGG HARBOR
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1669515516
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3515 BARGAINTOWN RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EGG HARBOR TOWNSHIP
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08234-8317
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
609-926-4044
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3125 FIRE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EGG HARBOR TOWNSHIP
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08234-9601
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
609-383-0003
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/14/2007

Additional Information

Authorized Official

Authorized Official Last Name:
MILLER
Authorized Official First Name:
PETER
Authorized Official Middle Name:
A
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
609-926-4044

Provider Taxonomy Codes

  • Taxonomy code: 341600000X , with the licence number:  EHT03106 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0041459 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2264666000 . This is a "INDEPENDENCE BLUE CROSS" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 2264666000 . This is a "ELECTRONIC AMERIHEALTH" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: P00147449 . This is a "MEDICARE RAILROAD" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 2264666000 . This is a "KEYSTONE" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 60004051 . This is a "HORIZON NJ HEALTH" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 91001253300 . This is a "AMERICHOICE NUMBER" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".




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