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Organization
PULASKI MEDICAL, LLC
Active
Organization
PULASKI MEDICAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBYN TANIS (EXECUTIVE DIRECTOR OF CONTRACT MGMT)
(856) 533-8762
Entity
Organization
Contact information
Practice address
1006 E MAIN ST, 1006, PULASKI, VA 24301-5218
(540) 980-1125
(540) 908-1127
Mailing address
1317 ROUTE 73 STE 200, MOUNT LAUREL, NJ 08054-2202
(856) 439-6111
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261QM2800X
Methadone Clinic
Primary
—
—
261QR0800X
Recovery Care Clinic/Center
—
—
Other
Enumeration date
12/21/2012
Last updated
11/21/2023
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