Provider Demographics
NPI:1912307042
Name:NU SPECTRUM WOUND CARE LIMITED LIABILITY COMPANY
Entity Type:Organization
Organization Name:NU SPECTRUM WOUND CARE LIMITED LIABILITY COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP- BUSINESS DEVELOPMENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MOSES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-823-4880
Mailing Address - Street 1:823 E GATE DR
Mailing Address - Street 2:SUITE 3A
Mailing Address - City:MOUNT LAUREL
Mailing Address - State:NJ
Mailing Address - Zip Code:08054-1202
Mailing Address - Country:US
Mailing Address - Phone:856-823-4880
Mailing Address - Fax:
Practice Address - Street 1:823 E GATE DR
Practice Address - Street 2:SUITE 3A
Practice Address - City:MOUNT LAUREL
Practice Address - State:NJ
Practice Address - Zip Code:08054-1202
Practice Address - Country:US
Practice Address - Phone:856-823-4880
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-26
Last Update Date:2014-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ0400676981332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies