Src Pending Consult Management
NPI #1366433534 in Fort Dix, New Jersey
Provider Information
- NPI Number
- 1366433534
- Entity Type
- Organization
- Organization Name
- Src Pending Consult Management
- Primary Specialty
- Clinic/Center
- Enumeration Date
- Nov 4, 2005
- Last Updated
- Aug 22, 2020
Practice Location
- Address
- 5250 MARYLAND AVE
- City
- Fort Dix
- State
- New Jersey
- ZIP Code
- 08640-5058
- Phone
- (609) 562-6312
Authorized Official
- Name
- MS. CHRISTALA CHERRY, RN, BSN
- Title
- CASE MANAGER
- Phone
- (609) 562-6312
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center |
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