Provider Demographics
NPI:1952310351
Name:BEDMINSTER CHIROPRACTIC INC
Entity Type:Organization
Organization Name:BEDMINSTER CHIROPRACTIC INC
Other - Org Name:BEDMINSTER CHIROPRACTIC INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING
Authorized Official - Prefix:MRS
Authorized Official - First Name:CONCETTA
Authorized Official - Middle Name:O
Authorized Official - Last Name:ROTHE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-781-9600
Mailing Address - Street 1:PO BOX 338
Mailing Address - Street 2:318 RT 202/206
Mailing Address - City:PLUCKEMIN
Mailing Address - State:NJ
Mailing Address - Zip Code:07978
Mailing Address - Country:US
Mailing Address - Phone:908-781-9600
Mailing Address - Fax:908-781-7761
Practice Address - Street 1:318 RT 202/206
Practice Address - Street 2:
Practice Address - City:PLUCKEMIN
Practice Address - State:NJ
Practice Address - Zip Code:07978
Practice Address - Country:US
Practice Address - Phone:908-781-9600
Practice Address - Fax:908-781-7761
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-05
Last Update Date:2014-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
T88958Medicare UPIN
SI573849Medicare ID - Type Unspecified