Provider Demographics
NPI:1285843581
Name:MONMOUTH COUNTY REGIONAL HEALTH COMMISSION #1
Entity Type:Organization
Organization Name:MONMOUTH COUNTY REGIONAL HEALTH COMMISSION #1
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE ASSISTANT
Authorized Official - Prefix:MRS
Authorized Official - First Name:PEGGY
Authorized Official - Middle Name:T
Authorized Official - Last Name:HUIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-493-9520
Mailing Address - Street 1:1540 WEST PARK AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:OCEAN TWP
Mailing Address - State:NJ
Mailing Address - Zip Code:07712-3156
Mailing Address - Country:US
Mailing Address - Phone:732-493-9520
Mailing Address - Fax:732-493-9525
Practice Address - Street 1:1540 WEST PARK AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:OCEAN TWP
Practice Address - State:NJ
Practice Address - Zip Code:07712-3156
Practice Address - Country:US
Practice Address - Phone:732-493-9520
Practice Address - Fax:732-493-9525
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-22
Last Update Date:2009-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJC56607251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ918718Medicare ID - Type UnspecifiedSOURCE #
NJ518651Medicare ID - Type UnspecifiedPROVIDER #