1609291251 NPI number — SOS GROUP INC

Table of content: JOHN FRANCIS ROYER D.O. (NPI 1417376484)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609291251 NPI number — SOS GROUP INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SOS GROUP 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:
6
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:
1609291251
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/18/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1829 N BLACK HORSE PIKE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WILLIAMSTOWN
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08094-3464
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
856-740-4000
Provider Business Mailing Address Fax Number:
856-740-4044

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1809 N BLACK HORSE PIKE STE 12
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WILLIAMSTOWN
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08094-9137
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
856-740-4000
Provider Business Practice Location Address Fax Number:
856-740-4044
Provider Enumeration Date:
02/19/2014

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
MURATORE
Authorized Official First Name:
ALYSSA
Authorized Official Middle Name:
KATHERINE
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
856-740-4000

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X , with the licence number:  13VH07385200 , 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)