Provider Demographics
NPI:1356348049
Name:ENVIRONMENTAL HEALTH SCIENCE, INC
Entity type:Organization
Organization Name:ENVIRONMENTAL HEALTH SCIENCE, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:S
Authorized Official - Last Name:GOLDBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-841-8923
Mailing Address - Street 1:418 WALL ST
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540-1504
Mailing Address - Country:US
Mailing Address - Phone:800-841-8923
Mailing Address - Fax:609-924-0793
Practice Address - Street 1:418 WALL ST
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-1504
Practice Address - Country:US
Practice Address - Phone:800-841-8923
Practice Address - Fax:609-924-0793
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0539155Medicaid
TN4582298Medicaid
WI82389200Medicaid
PA0010971660002Medicaid
MA1540696Medicaid
AZ931114Medicaid
NM000G4575Medicaid
ND54128Medicaid
DE0000599416Medicaid
NJ3155200Medicaid
CO91779049Medicaid
NY01130189Medicaid
NC05353058Medicaid
MS0440878Medicaid
RI1160001Medicaid
CO91779049Medicaid
IA0539155Medicaid