Provider Demographics
NPI:1295943298
Name:FRANKLIN TOWNSHIP
Entity type:Organization
Organization Name:FRANKLIN TOWNSHIP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:JUDSON
Authorized Official - Middle Name:
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-694-1234
Mailing Address - Street 1:PO BOX 1016
Mailing Address - Street 2:
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-7016
Mailing Address - Country:US
Mailing Address - Phone:856-784-3715
Mailing Address - Fax:
Practice Address - Street 1:1571 DELSEA DR
Practice Address - Street 2:
Practice Address - City:FRANKLINVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08322-2391
Practice Address - Country:US
Practice Address - Phone:856-694-1234
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2013-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJFRN103103416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3846657OtherAETNA
NJ60013477OtherHORIZON MERCY
NJ91001722300OtherAMERICHOICE
NJ0083810Medicaid
NJ2374496000OtherAMERIHEALTH
NJ91001722300OtherAMERICHOICE