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General NPI Number Information
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NPI Number | 1174994701
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Entity Type | Organization
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Legal Business Name | PATIENT FIRST NEW JERSEY PHYSICIANS GROUP LLC
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Dates
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Enumeration Date | 10/08/2015
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Last Update Date | 12/07/2023
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Provider Practice Location Address
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Address Line | 4000 ROUTE 130 BUILDING C
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City | DELRAN
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State | NJ
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Zip | 08075-2414
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Country | US
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Telephone | 856-705-0685
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Fax | 856-705-0680
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Provider Business Mailing Address
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Address Line | 5000 COX RD STE 100
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City | GLEN ALLEN
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State | VA
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Zip | 23060-9263
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Country | US
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Telephone | 804-822-4383
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Fax | 804-965-0987
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Authorized Official
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Title or Position | PHARMACY MANAGER
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Name | ELWOOD PITTS JR.
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Credential |
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Telephone | 804-822-4588
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332900000X
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Taxonomy Name | Non-Pharmacy Dispensing Site
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License Number | 25MB02134500
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License Number State | NJ
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