Provider Demographics
NPI:1336538701
Name:PATIENT FIRST NEW JERSEY PHYSICIANS GROUP LLC
Entity Type:Organization
Organization Name:PATIENT FIRST NEW JERSEY PHYSICIANS GROUP LLC
Other - Org Name:PATIENT FIRST WOODBURY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ELWOOD
Authorized Official - Middle Name:
Authorized Official - Last Name:PITTS
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:804-822-4588
Mailing Address - Street 1:5000 COX RD
Mailing Address - Street 2:STE 100
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23060-9263
Mailing Address - Country:US
Mailing Address - Phone:804-822-4383
Mailing Address - Fax:804-965-0987
Practice Address - Street 1:630 MANTUA PIKE
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:NJ
Practice Address - Zip Code:08096-3233
Practice Address - Country:US
Practice Address - Phone:856-812-2220
Practice Address - Fax:856-812-2221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-22
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA09608800332900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site