Provider Demographics
NPI:1023379542
Name:FOUNDATION RESEARCH MEDICAL SERVICES, P.C.
Entity Type:Organization
Organization Name:FOUNDATION RESEARCH MEDICAL SERVICES, P.C.
Other - Org Name:UNIVERSITY SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:GERSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:215-637-6800
Mailing Address - Street 1:10551 DECATUR RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19154-3800
Mailing Address - Country:US
Mailing Address - Phone:215-637-6800
Mailing Address - Fax:215-637-7967
Practice Address - Street 1:443 LAUREL OAK RD
Practice Address - Street 2:SUITE 210
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-4419
Practice Address - Country:US
Practice Address - Phone:856-741-7000
Practice Address - Fax:856-741-1004
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FOUNDATION RESEARCH MEDICAL SERVICES, P.C. T/A UNIVERSITY SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-05-31
Last Update Date:2012-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ125003870332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies