Healthcare Provider Details

I. General information

NPI: 1609450071
Provider Name (Legal Business Name): AMS NEW JERSEY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2021
Last Update Date: 05/11/2021
Certification Date: 05/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

317 GEORGE ST STE 320
NEW BRUNSWICK NJ
08901-2091
US

IV. Provider business mailing address

166 HARGRAVES DR # C400-235
AUSTIN TX
78737-4796
US

V. Phone/Fax

Practice location:
  • Phone: 866-787-8219
  • Fax:
Mailing address:
  • Phone: 866-787-8219
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: MRS. KATHERINE MCCOMMON
Title or Position: MANAGER
Credential:
Phone: 866-787-8219