# PHYSICIAN MANAGEMENT SERVICES OF NEW JERSEY, LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** VAXCARE CORPORATION
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1629348503
- **Legal business name:** VAXCARE CORPORATION
- **Authorized official:** CASEY DELOACH (MANAGER)
- **Authorized official phone:** (888) 829-8550

## Contact information

- **Practice address:** 170 CHANGEBRIDGE RD BLDG C3, MONTVILLE, NJ 07045-9112
- **Practice address phone:** (888) 829-8550
- **Mailing address:** 800 N MAGNOLIA AVE STE 700, ORLANDO, FL 32803-3264
- **Mailing address phone:** (888) 829-8550
- **Mailing address fax:** (859) 422-4907

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 01/09/2012
- **Last updated:** 07/24/2026