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General NPI Number Information
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NPI Number | 1902940901
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Entity Type | Organization
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Legal Business Name | FORREST S. CHILTON 3RD MEMORIAL HOSPITAL ASSOCIATION
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Dates
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Enumeration Date | 02/16/2007
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Last Update Date | 07/09/2008
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Provider Practice Location Address
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Address Line | 97 WEST PARKWAY
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City | POMPTON PLAINS
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State | NJ
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Zip | 07444-1647
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Country | US
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Telephone | 973-831-5202
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Fax | 973-831-5493
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Provider Business Mailing Address
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Address Line | 97 WEST PARKWAY
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City | POMPTON PLAINS
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State | NJ
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Zip | 07444-1647
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Country | US
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Telephone | 973-831-5202
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Fax | 973-831-5493
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | MR. MICHAEL A RICHETTI
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Credential | C.P.A.
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Telephone | 973-831-5202
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 273R00000X
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Taxonomy Name | Psychiatric Hospital Unit
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License Number | FACILITY 11401
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License Number State | NJ
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