Provider Demographics
NPI:1861483299
Name:ASHURST FAMILY PHYSICIANS, PA
Entity Type:Organization
Organization Name:ASHURST FAMILY PHYSICIANS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:J
Authorized Official - Last Name:BROSS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:609-702-5510
Mailing Address - Street 1:1561 ROUTE 38
Mailing Address - Street 2:SUITE 6A
Mailing Address - City:LUMBERTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08048-2939
Mailing Address - Country:US
Mailing Address - Phone:609-702-5510
Mailing Address - Fax:609-267-0642
Practice Address - Street 1:1561 ROUTE 38
Practice Address - Street 2:SUITE 6
Practice Address - City:LUMBERTON
Practice Address - State:NJ
Practice Address - Zip Code:08048-2939
Practice Address - Country:US
Practice Address - Phone:206-702-5510
Practice Address - Fax:609-267-0642
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3183602Medicaid
NJ3183602Medicaid