1780081257 NPI number — SPRINGPOINT AT MEADOW LAKES, 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 1780081257 NPI number — SPRINGPOINT AT MEADOW LAKES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SPRINGPOINT AT MEADOW LAKES, 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:
MEADOW LAKES
Provider Other Organization Name Type Code:
3
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:
1780081257
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/01/2016
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:
300 MEADOW LKS
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HIGHTSTOWN
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08520-4804
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
609-426-6801
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/01/2014

Additional Information

			
		

Authorized Official

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

Provider Taxonomy Codes

  • Taxonomy code: 310400000X , with the licence number:  47A001 , 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: 0188247 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".