1811013873 NPI number — TOWNSHIP OF WESTAMPTON

Table of content: (NPI 1811013873)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1811013873 NPI number — TOWNSHIP OF WESTAMPTON

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TOWNSHIP OF WESTAMPTON
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:
1811013873
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/21/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 467
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LUMBERTON
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08048
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
609-261-1002
Provider Business Mailing Address Fax Number:
609-261-6088

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
710 RANCOCAS ROAD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WESTAMPTON
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08060-5642
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
609-267-2041
Provider Business Practice Location Address Fax Number:
609-267-7398
Provider Enumeration Date:
03/21/2007

Additional Information

Authorized Official

Authorized Official Last Name:
JOHNSON
Authorized Official First Name:
WYLIE
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIEF
Authorized Official Telephone Number:
856-784-3715

Provider Taxonomy Codes

  • Taxonomy code: 341600000X , with the licence number:  WEST00650 , 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: 0099872 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1118670 . This is a "HORIZON NJ HEALTH" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 0058256000 . This is a "AMERIHEALTH" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 0058256000 . This is a "KEYSTONE" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 910000096800 . This is a "AMERICHOICE" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 2234343 . This is a "AETNA" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".




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