Healthcare Provider Details
I. General information
NPI: 1962208819
Provider Name (Legal Business Name): ENSPIRE CONSULTING GROUP HAMMONTON LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/21/2025
Last Update Date: 05/20/2025
Certification Date: 05/20/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
630 S WHITE HORSE PIKE UNIT B
HAMMONTON NJ
08037-2014
US
IV. Provider business mailing address
630 S WHITE HORSE PIKE UNIT B
HAMMONTON NJ
08037-2014
US
V. Phone/Fax
- Phone: 215-845-5869
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM1300X |
| Taxonomy | Multi-Specialty Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
FRANK
EDWARDS
Title or Position: CEO
Credential:
Phone: 215-219-9333