Organization
SMD DESTINED, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMPSON DAVIS (PRESIDENT)
(201) 392-3210
Entity
Organization
Contact information
Practice address
55 MEADOWLANDS PKWY, SECAUCUS, NJ 07094-2977
(201) 392-3210
Mailing address
26-40 CHURCH ST, UNIT 9, SOUTH ORANGE, NJ 07079-1777
(201) 392-3210
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
25MA07204500
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9089209
—
NJ
Enumeration date
02/01/2014
Last updated
02/01/2014
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