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Organization

SRC PENDING CONSULT MANAGEMENT

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. CHRISTALA CHERRY RN, BSN (CASE MANAGER)
(609) 562-6312
Entity
Organization

Contact information

Practice address
5250 MARYLAND AVE, FORT DIX, NJ 08640-5058
(609) 562-6312
Mailing address
1312 PARIS CT, LAKEWOOD, NJ 08701-3724
(732) 267-7737

Taxonomy

Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
26NR09534400
NJ

Other

Enumeration date
11/04/2005
Last updated
08/22/2020
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