ANNANDALE FAMILY PRACTICE LLC (NPI# 1467793141) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467793141 |
| Entity Type | Organization |
| Organization Name | ANNANDALE FAMILY PRACTICE LLC |
| Other Organization Name | ANNANDALE FAMILY PRACTICE |
| Practice Address |
56 Payne Rd Suite 21 Lebanon NJ 08833-3262 |
| Mailing Address |
5626 Oberlin Dr Suite 110 San Diego CA 92121-1705 |
| Practice Telephone | 9082380100 |
| Enumeration Date | 2013-03-06 |
| Last Update Date | 2013-03-06 |
| Authorized Official Name | KENNY HEINE (VP OF OPERATIONS) |
| Authorized Official Telephone | 8589641506 |
| Is Organization Subpart | Y |
| Parent Organization Name | MEDVANTX, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332900000X | Non-Pharmacy Dispensing Site | 25MA07764100 | NJ | Suppliers |
| Other Name | Type Code |
|---|---|
| Annandale Family Practice | Doing Business As Name - Organization |
| Street Address |
56 PAYNE RD SUITE 21 |
| City | LEBANON |
| State | NJ |
| Zip Code | 08833-3262 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578616942 | Theresa Ann Sacchieri | Family Medicine | 56 Payne Rd, Suite 21, Lebanon, NJ 08833-3262 | 2007-01-19 |
| 1003080169 | Annandale Family Practice, LLC | Clinic/Center | 56 Payne Rd, Suite 21, Lebanon, NJ 08833-3262 | 2008-04-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720692692 | Mackenzie Weiss | Physical Therapist | 1390 Route 22 West, Suite 203, Lebanon, NJ 08833 | 2020-09-08 |
| 1255821294 | William D. Campagna | Psychologist | 1220 State Route 31, Ste. 19, Lebanon, NJ 08833 | 2018-05-15 |
| 1164923462 | Alison Hartman | Physical Therapist | 1250 Route 31 North, Lebanon, NJ 08833 | 2018-02-22 |
| 1912383787 | Yanchew Tan | Reflexologist | 349 Applegarth Road, Monroe Twp, NJ 08833 | 2015-08-04 |
| 1588089437 | Stephanie Charnigo | Physical Therapist | 1250 Rt. 31, Lebanon, NJ 08833 | 2014-03-03 |
| 1487901799 | Somerset Hills Endodontics, PC | Dentist | 1392 Route 22 West, Suite 2, Lebanon, NJ 08833 | 2012-08-07 |
| 1538382858 | Thomas John Jaeger | Dentist | 1128 Route 31, Lebanon, NJ 08833 | 2007-04-11 |
| 1083755599 | Ronald Frederick Heeren | Chiropractor | 1360 Rt 22 West, Suite 3, Lebanon, NJ 08833 | 2007-02-08 |
| 1609943885 | David Vining Holbrook | Psychiatry & Neurology | 1109 Stare Hwy No 31, Apt A, Lebanon, NJ 08833 | 2006-11-30 |
| 1609949593 | Jody Lawrence Serra | Chiropractor | 1356 Us Hwy 22 West, Lebanon, NJ 08833 | 2006-11-16 |
| Find all providers in zip 08833 | ||||
| Taxonomy Code | 332900000X |
| Grouping | Suppliers |
| Classification | Non-Pharmacy Dispensing Site |
| A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.) |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659906709 | Tennessee Oncology Pharmacy Dispensing | Non-Pharmacy Dispensing Site | 103 Physicians Way Ste 102, Lebanon, TN 37090-4132 | 2020-03-10 |
| 1164826285 | Community Quick Care | Non-Pharmacy Dispensing Site | 1670 W Main St Ste 140, Lebanon, TN 37087-1345 | 2014-10-17 |
| 1497051809 | Tennessee Oncology Pharmacy Dispensing | Non-Pharmacy Dispensing Site | 115 Winwood Dr, Ste 205, Lebanon, TN 37087-1340 | 2011-02-02 |
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| 1326493040 | Caligor Opco LLC | Non-Pharmacy Dispensing Site | 801 Penhorn Ave, Unit #4, Secaucus, NJ 07094-2150 | 2016-05-02 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.