Healthcare Provider Details

I. General information

NPI: 1518471895
Provider Name (Legal Business Name): URMAJESTY BANKTRUCKFIT SOLUTIONS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/26/2017
Last Update Date: 11/26/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 BENEDETTE DR
WATERFORD WORKS NJ
08089-2440
US

IV. Provider business mailing address

6 BENEDETTE DR
WATERFORD WORKS NJ
08089-2440
US

V. Phone/Fax

Practice location:
  • Phone: 561-808-6519
  • Fax: 561-808-6519
Mailing address:
  • Phone: 561-808-6519
  • Fax: 561-808-6519

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code276400000X
TaxonomySubstance Use Disorder Rehabilitation Hospital Unit
License Number
License Number State

VIII. Authorized Official

Name: TROY MCNAIR
Title or Position: CEO
Credential:
Phone: 561-808-6519