Healthcare Provider Details

I. General information

NPI: 1992033955
Provider Name (Legal Business Name): PREFERRED HEALTH SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2009
Last Update Date: 12/01/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3966A BROWN CT
MC GUIRE AFB NJ
08641-1649
US

IV. Provider business mailing address

PO BOX 669
COOKSTOWN NJ
08511-0669
US

V. Phone/Fax

Practice location:
  • Phone: 609-724-0090
  • Fax:
Mailing address:
  • Phone: 609-724-0090
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SUNDAY N LAIRD
Title or Position: PROVIDER
Credential: PA
Phone: 609-724-0090