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General NPI Number Information
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NPI Number | 1902107964
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Entity Type | Organization
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Legal Business Name | MED-X @HOME
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Dates
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Enumeration Date | 11/08/2010
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Last Update Date | 11/08/2010
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Provider Practice Location Address
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Address Line | 540 BORDENTOWN AVE STE 4550
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City | SOUTH AMBOY
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State | NJ
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Zip | 08879-1546
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Country | US
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Telephone | 732-721-3700
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Fax | 732-721-2860
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Provider Business Mailing Address
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Address Line | PO BOX 715
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City | MATAWAN
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State | NJ
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Zip | 07747-0715
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Country | US
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Telephone | 732-721-3700
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Fax | 732-721-2860
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | LEONARD AUGUST
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Credential |
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Telephone | 732-721-3700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 347E00000X
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Taxonomy Name | Transportation Broker
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License Number |
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License Number State |
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