Provider Demographics
NPI:1376812628
Name:JMBL
Entity Type:Organization
Organization Name:JMBL
Other - Org Name:HEALTH FAIRS DIRECT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CORPORATE WELLNESS SPECIALIST
Authorized Official - Prefix:MS
Authorized Official - First Name:ROSE
Authorized Official - Middle Name:
Authorized Official - Last Name:MORROW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-688-5550
Mailing Address - Street 1:18 HAMILTON ST
Mailing Address - Street 2:STE 1
Mailing Address - City:BOUND BROOK
Mailing Address - State:NJ
Mailing Address - Zip Code:08805-1768
Mailing Address - Country:US
Mailing Address - Phone:646-688-5550
Mailing Address - Fax:
Practice Address - Street 1:18 HAMILTON ST
Practice Address - Street 2:STE 1
Practice Address - City:BOUND BROOK
Practice Address - State:NJ
Practice Address - Zip Code:08805-1768
Practice Address - Country:US
Practice Address - Phone:646-688-5550
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-15
Last Update Date:2012-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07622400251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJP4403347OtherOXFORD HEALTH PLANS
9796841OtherAETNA
3387703OtherUHC
NJSCE98OtherEMPIRE BC BS