Provider Demographics
NPI:1932296753
Name:MED-STAT HEALTHCARE INC
Entity Type:Organization
Organization Name:MED-STAT HEALTHCARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:KUREEKATTIL
Authorized Official - Last Name:JOY
Authorized Official - Suffix:
Authorized Official - Credentials:RRT
Authorized Official - Phone:973-429-4994
Mailing Address - Street 1:150 ORANGE ST
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07003-4704
Mailing Address - Country:US
Mailing Address - Phone:973-429-4994
Mailing Address - Fax:973-429-8390
Practice Address - Street 1:150 ORANGE ST
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07003-4704
Practice Address - Country:US
Practice Address - Phone:973-429-4994
Practice Address - Fax:973-429-8390
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-05
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8554609Medicaid
NJ8554609Medicaid