# SMD DESTINED, INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114340791
- **Authorized official:** SAMPSON DAVIS (PRESIDENT)
- **Authorized official phone:** (201) 392-3210

## Contact information

- **Practice address:** 55 MEADOWLANDS PKWY, SECAUCUS, NJ 07094-2977
- **Practice address phone:** (201) 392-3210
- **Mailing address:** 26-40 CHURCH ST, UNIT 9, SOUTH ORANGE, NJ 07079-1777
- **Mailing address phone:** (201) 392-3210

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 282N00000X | General Acute Care Hospital | 25MA07204500 | NJ | Yes |

## Other

- **Enumeration date:** 02/01/2014
- **Last updated:** 02/01/2014