Organization · Type 2 NPI
SRC Pending Consult Management
Clinic/Center · Fort Dix, NJ
NPI number
1366433534
Active
Practice location
5250 Maryland Ave
Fort Dix, NJ 08640-5058
Mailing address
1312 Paris Ct
Lakewood, NJ 08701-3724
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Clinic/Center Primary | 261Q00000X | 26NR09534400 (NJ) |
Clinic/Center: 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).
2 other providers at this address
About NPI 1366433534
SRC Pending Consult Management's National Provider Identifier is 1366433534, issued on Nov 4, 2005. The primary taxonomy on file is Clinic/Center (261Q00000X), and the practice location is in Fort Dix, NJ. The record was last updated on Aug 22, 2020.