Provider Demographics
NPI:1679087407
Name:NEXTRON MEDICAL TECHNOLOGIES INC.
Entity type:Organization
Organization Name:NEXTRON MEDICAL TECHNOLOGIES INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:LAWRENCE
Authorized Official - Last Name:KATEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:772-631-3140
Mailing Address - Street 1:6912 S QUENTIN ST STE 50
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80112-4531
Mailing Address - Country:US
Mailing Address - Phone:720-282-5325
Mailing Address - Fax:877-676-0493
Practice Address - Street 1:11 COMMERCE WAY STE H
Practice Address - Street 2:
Practice Address - City:TOTOWA
Practice Address - State:NJ
Practice Address - Zip Code:07512
Practice Address - Country:US
Practice Address - Phone:973-575-0614
Practice Address - Fax:973-575-4580
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AMERITA, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-12-01
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ5005066332BP3500X, 332B00000X
NJ28RS004598003336H0001X, 3336S0011X
335G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
No335G00000XSuppliersMedical Foods Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
3140770OtherNCPDP
NJ0606171Medicaid
NJ5014808Medicaid
PA103253781Medicaid