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Organization
MID JERSEY RESP. ASSOCIATES, MEDICAL SUPPLIES & CLINICAL SVCS., INC
Active
Organization
MID JERSEY RESP. ASSOCIATES, MEDICAL SUPPLIES & CLINICAL SVCS., INC
Active
Other names
MJRA
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JORGE LUIS GONZALEZ-GOMEZ R.R.T., C.F.O. (CEO)
(732) 721-0028
Entity
Organization
Contact information
Practice address
106 1/2 N BROADWAY, BOX 98, SOUTH AMBOY, NJ 08879-1706
(732) 721-0028
(732) 721-0008
Mailing address
106 1/2 N BROADWAY, BOX 98, SOUTH AMBOY, NJ 08879-1706
(732) 721-0028
(732) 721-0008
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
43ZA00010300
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0099287
—
NJ
01
—
010002125-00
AMERICHOICE OF NJ
NJ
01
—
575943
AETNA
NJ
05
—
6400001
—
NJ
Enumeration date
03/18/2006
Last updated
08/22/2020
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