Provider Demographics
NPI:1942570510
Name:LAKEWOOD RESOURCE & REFERRAL CENTER
Entity Type:Organization
Organization Name:LAKEWOOD RESOURCE & REFERRAL CENTER
Other - Org Name:CENTER FOR HEALTH EDUCATION MEDICINE & DENTISTRY (CHEMED)
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:FRIEDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-534-8559
Mailing Address - Street 1:1771 MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-1251
Mailing Address - Country:US
Mailing Address - Phone:732-537-8559
Mailing Address - Fax:732-534-8071
Practice Address - Street 1:1771 MADISON AVE
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-1251
Practice Address - Country:US
Practice Address - Phone:732-537-8559
Practice Address - Fax:732-534-8071
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-12
Last Update Date:2012-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RS00716900333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy