1295943298 NPI number — FRANKLIN TOWNSHIP

Table of content: (NPI 1295943298)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1295943298 NPI number — FRANKLIN TOWNSHIP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FRANKLIN TOWNSHIP
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:
1295943298
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/25/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1016
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
VOORHEES
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08043-7016
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
856-784-3715
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1571 DELSEA DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FRANKLINVILLE
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08322-2391
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
856-694-1234
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/21/2007

Additional Information

Authorized Official

Authorized Official Last Name:
MOORE
Authorized Official First Name:
JUDSON
Authorized Official Middle Name:
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
856-694-1234

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , with the licence number:  FRN10310 , 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: 3846657 . This is a "AETNA" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 60013477 . This is a "HORIZON MERCY" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 91001722300 . This is a "AMERICHOICE" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 0083810 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2374496000 . This is a "AMERIHEALTH" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com