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General NPI Number Information
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NPI Number | 1083778336
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Entity Type | Organization
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Legal Business Name | RTA PEDIATRIC CARE INC
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Dates
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Enumeration Date | 12/21/2006
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Last Update Date | 07/21/2023
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Provider Practice Location Address
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Address Line | 882 S DELSEA DR
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City | VINELAND
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State | NJ
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Zip | 08360-4464
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Country | US
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Telephone | 856-697-8002
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Fax | 856-697-8003
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Provider Business Mailing Address
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Address Line | 106 W LANDIS AVE UNIT 10
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City | VINELAND
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State | NJ
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Zip | 08360-8114
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Country | US
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Telephone | 856-794-8050
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Fax | 856-794-8051
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Authorized Official
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Title or Position | PRESIDENT CEO
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Name | MR. BART H PRICE
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Credential | RRT
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Telephone | 856-794-8050
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | C0000038207
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License Number State | NJ
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