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Src Pending Consult Management
Clinic/Center in Fort Dix, New Jersey
NPI 1366433534

Src Pending Consult Management is a Clinic/Center based in Lakewood, NJ. Src Pending Consult Management practices in Fort Dix, NJ. The NPI Number for Src Pending Consult Management is 1366433534 and holds a License No. 26NR09534400 (New Jersey).

The current practice location address for Src Pending Consult Management is 5250 Maryland Ave, Fort Dix, NJ and can be reached out via phone at 609-562-6312.

Location: 5250 Maryland Ave, Fort Dix, NJ, 08701-3724
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1366433534
Provider Name
Src Pending Consult Management
Credential
Provider Entity Type
Organization
Address
5250 Maryland Ave, Fort Dix, NJ, 08701-3724
Phone Number
609-562-6312
Fax Number
Provider Enumeration Date
11/04/2005
Last Update Date
03/08/2024
institution
Provider Business Practice Location Address Details
Address
5250 Maryland Ave
City
Fort Dix
State
New Jersey
Zip
08640-5058
Phone Number
609-562-6312
Fax Number
person
Provider Business Mailing Address Details
Address
5250 Maryland Ave
City
Fort Dix
State
New Jersey
Zip
08640-5058
Phone Number
609-562-6312
Fax Number
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
-
Taxonomy
261Q00000X
License No.
26NR09534400 (New Jersey)
Definition
A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
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