Organization
PHYSICIAN MANAGEMENT SERVICES OF NEW JERSEY, LLC
Active
Parent organization
VAXCARE CORPORATION
Organization subpart
Yes
Provider details
NPI number
Legal business name
VAXCARE CORPORATION
Authorized official
CASEY DELOACH (MANAGER)
(888) 829-8550
Entity
Organization
Contact information
Practice address
170 CHANGEBRIDGE RD BLDG C3, MONTVILLE, NJ 07045-9112
(888) 829-8550
Mailing address
3113 LAWTON RD STE 250, ORLANDO, FL 32803-3517
(888) 829-8550
(859) 422-4907
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
01/09/2012
Last updated
10/13/2020
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