Provider Demographics
NPI:1245610104
Name:PAFACOM, INC.
Entity Type:Organization
Organization Name:PAFACOM, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:TY
Authorized Official - Last Name:VERNAMONTI
Authorized Official - Suffix:
Authorized Official - Credentials:MS, BA
Authorized Official - Phone:856-696-1661
Mailing Address - Street 1:1301 W FOREST GROVE RD
Mailing Address - Street 2:BUILDING 3C
Mailing Address - City:VINELAND
Mailing Address - State:NJ
Mailing Address - Zip Code:08360-1501
Mailing Address - Country:US
Mailing Address - Phone:856-696-1661
Mailing Address - Fax:856-691-6560
Practice Address - Street 1:431 SMITH RD
Practice Address - Street 2:
Practice Address - City:MILLVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08332-4156
Practice Address - Country:US
Practice Address - Phone:856-825-5416
Practice Address - Fax:856-691-6560
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-05
Last Update Date:2015-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health