Provider Demographics
NPI:1205556057
Name:4FAM QUALITY CARE LLC
Entity type:Organization
Organization Name:4FAM QUALITY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:APN
Authorized Official - Prefix:MR
Authorized Official - First Name:ZACHARIAH
Authorized Official - Middle Name:G
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:APN
Authorized Official - Phone:856-693-5859
Mailing Address - Street 1:2959 DELSEA DR
Mailing Address - Street 2:
Mailing Address - City:FRANKLINVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08322-2921
Mailing Address - Country:US
Mailing Address - Phone:856-693-5859
Mailing Address - Fax:
Practice Address - Street 1:2959 DELSEA DR
Practice Address - Street 2:
Practice Address - City:FRANKLINVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08322-2921
Practice Address - Country:US
Practice Address - Phone:856-693-5859
Practice Address - Fax:856-367-5130
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-31
Last Update Date:2022-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty