Healthcare Provider Details

I. General information

NPI: 1760776843
Provider Name (Legal Business Name): HELLSTONE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/06/2011
Last Update Date: 08/21/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1004 1/2 FANNY ST 1R
ELIZABETH NJ
07201-1693
US

IV. Provider business mailing address

PO BOX 2789
ELIZABETH NJ
07207-2789
US

V. Phone/Fax

Practice location:
  • Phone: 862-246-6245
  • Fax:
Mailing address:
  • Phone: 862-246-6245
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171R00000X
TaxonomyInterpreter
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code344600000X
TaxonomyTaxi
License Number
License Number State

VIII. Authorized Official

Name: MR. EDRIS L STONE
Title or Position: PRESIDENT
Credential:
Phone: 862-246-6245