Provider Demographics
NPI:1962650457
Name:WEST DEPTFORD ANIMAL HOSPITAL
Entity Type:Organization
Organization Name:WEST DEPTFORD ANIMAL HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:J
Authorized Official - Last Name:FARGHER
Authorized Official - Suffix:
Authorized Official - Credentials:VMD
Authorized Official - Phone:856-464-8567
Mailing Address - Street 1:1044 MANTUA PIKE
Mailing Address - Street 2:RT 45
Mailing Address - City:WENONAH
Mailing Address - State:NJ
Mailing Address - Zip Code:08090-1124
Mailing Address - Country:US
Mailing Address - Phone:856-464-8567
Mailing Address - Fax:856-464-0313
Practice Address - Street 1:1044 MANTUA PIKE
Practice Address - Street 2:RT 45
Practice Address - City:WENONAH
Practice Address - State:NJ
Practice Address - Zip Code:08090-1124
Practice Address - Country:US
Practice Address - Phone:856-464-8567
Practice Address - Fax:856-464-0313
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-09
Last Update Date:2008-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJVI 003231174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174M00000XOther Service ProvidersVeterinarianGroup - Single Specialty