1518088558 NPI number — SPRINGPOINT AT THE ATRIUM, INC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518088558 NPI number — SPRINGPOINT AT THE ATRIUM, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SPRINGPOINT AT THE ATRIUM, INC
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:
1518088558
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/16/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4814 OUTLOOK DR
Provider Second Line Business Mailing Address:
SUITE 201
Provider Business Mailing Address City Name:
WALL TOWNSHIP
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07753-6812
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
732-430-3650
Provider Business Mailing Address Fax Number:
732-430-3711

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
40 RIVERSIDE AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
RED BANK
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07701-1025
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
732-784-9800
Provider Business Practice Location Address Fax Number:
732-842-4934
Provider Enumeration Date:
04/03/2007

Additional Information

Authorized Official

Authorized Official Last Name:
MIDGETT
Authorized Official First Name:
GARRETT
Authorized Official Middle Name:
Authorized Official Title or Position:
SR VP/CFO
Authorized Official Telephone Number:
732-430-3675

Provider Taxonomy Codes

  • Taxonomy code: 310400000X , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 314000000X , 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: 0397750 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".




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