Provider Demographics
NPI:1598360273
Name:FREE VACCINE FOR ALL COMMUNITY HEALTH CLINIC
Entity Type:Organization
Organization Name:FREE VACCINE FOR ALL COMMUNITY HEALTH CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LI
Authorized Official - Middle Name:
Authorized Official - Last Name:JIANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-240-8285
Mailing Address - Street 1:613 COURTYARD DR
Mailing Address - Street 2:
Mailing Address - City:HILLSBOROUGH
Mailing Address - State:NJ
Mailing Address - Zip Code:08844-4256
Mailing Address - Country:US
Mailing Address - Phone:908-240-8285
Mailing Address - Fax:
Practice Address - Street 1:613 COURTYARD DR
Practice Address - Street 2:
Practice Address - City:HILLSBOROUGH
Practice Address - State:NJ
Practice Address - Zip Code:08844-4256
Practice Address - Country:US
Practice Address - Phone:908-240-8285
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-01
Last Update Date:2020-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service