Provider Demographics
NPI:1407971872
Name:GALLOPING HILL SURGICAL, LLC
Entity Type:Organization
Organization Name:GALLOPING HILL SURGICAL, LLC
Other - Org Name:ALLCARE MEDICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:FUHRMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-251-8000
Mailing Address - Street 1:4470 BORDENTOWN AVE
Mailing Address - Street 2:
Mailing Address - City:OLD BRIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:08857-1737
Mailing Address - Country:US
Mailing Address - Phone:732-251-8000
Mailing Address - Fax:866-866-1056
Practice Address - Street 1:4470 BORDENTOWN AVE
Practice Address - Street 2:
Practice Address - City:OLD BRIDGE
Practice Address - State:NJ
Practice Address - Zip Code:08857-1737
Practice Address - Country:US
Practice Address - Phone:732-251-8000
Practice Address - Fax:866-866-1056
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-21
Last Update Date:2013-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6774903Medicaid
NJ1042980001Medicare NSC