Provider Demographics
NPI:1619075041
Name:MIDLANTIC MEDICAL SYSTEMS, INC
Entity Type:Organization
Organization Name:MIDLANTIC MEDICAL SYSTEMS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TOM
Authorized Official - Middle Name:
Authorized Official - Last Name:DEVINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-430-1300
Mailing Address - Street 1:61 FIELDSTONE RD
Mailing Address - Street 2:
Mailing Address - City:SKILLMAN
Mailing Address - State:NJ
Mailing Address - Zip Code:08558-1642
Mailing Address - Country:US
Mailing Address - Phone:908-432-4599
Mailing Address - Fax:908-904-0596
Practice Address - Street 1:145 WITHERSPOON ST
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08542-3228
Practice Address - Country:US
Practice Address - Phone:609-430-1300
Practice Address - Fax:609-430-1311
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2008-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies