Provider Demographics
NPI:1851565105
Name:SOUTH JERSEY HOME MEDICAL
Entity Type:Organization
Organization Name:SOUTH JERSEY HOME MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:PAPARONE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:609-652-2240
Mailing Address - Street 1:72 W JIMMIE LEEDS RD
Mailing Address - Street 2:
Mailing Address - City:GALLOWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08205-9406
Mailing Address - Country:US
Mailing Address - Phone:609-652-2240
Mailing Address - Fax:609-748-1029
Practice Address - Street 1:72 W JIMMIE LEEDS RD
Practice Address - Street 2:
Practice Address - City:GALLOWAY
Practice Address - State:NJ
Practice Address - Zip Code:08205-9406
Practice Address - Country:US
Practice Address - Phone:609-652-2240
Practice Address - Fax:609-748-1029
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PHILIPPAPARONEDO
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-04-17
Last Update Date:2008-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB2413200251F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251F00000XAgenciesHome Infusion