Healthcare Provider Details
I. General information
NPI: 1902349038
Provider Name (Legal Business Name): PATIENT FIRST NEW JERSEY PHYSICIANS GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/21/2016
Last Update Date: 12/07/2023
Certification Date: 12/07/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2171 ROUTE 70 W
CHERRY HILL NJ
08002-2733
US
IV. Provider business mailing address
5000 COX RD STE 100
GLEN ALLEN VA
23060-9263
US
V. Phone/Fax
- Phone: 856-406-0023
- Fax: 856-406-0024
- Phone: 804-822-4588
- Fax: 804-965-0987
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332900000X |
| Taxonomy | Non-Pharmacy Dispensing Site |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ELWOOD
PITTS
JR.
Title or Position: PHARMACY MANAGER
Credential:
Phone: 804-822-4588