Provider Demographics
NPI:1497463178
Name:INFUSION SERVICES OF SOUTH JERSEY LLC
Entity Type:Organization
Organization Name:INFUSION SERVICES OF SOUTH JERSEY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:SOLOWAY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:856-794-1003
Mailing Address - Street 1:PO BOX 2697
Mailing Address - Street 2:
Mailing Address - City:VINELAND
Mailing Address - State:NJ
Mailing Address - Zip Code:08362-2697
Mailing Address - Country:US
Mailing Address - Phone:856-794-1003
Mailing Address - Fax:856-794-9178
Practice Address - Street 1:2848 S DELSEA DR STE 3
Practice Address - Street 2:
Practice Address - City:VINELAND
Practice Address - State:NJ
Practice Address - Zip Code:08360-7042
Practice Address - Country:US
Practice Address - Phone:856-794-1003
Practice Address - Fax:856-794-9178
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-10
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion Therapy
No207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Multi-Specialty
No251F00000XAgenciesHome Infusion