Organization
MAYSVILLE MEDICAL, LLC
Active
Other names
Maysville Medical, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ROBYN TANIS (EXEC DIRECTOR CONTRACT MANAGEMENT)
(856) 533-8762
Entity
Organization
Contact information
Practice address
152 E 2ND ST, MAYSVILLE, KY 41056-1264
(606) 564-0303
Mailing address
1317 ROUTE 73, MOUNT LAUREL, NJ 08054-2202
(856) 533-8762
Taxonomy
Speciality
Code
Description
License number
State
261QM2800X
Methadone Clinic
Primary
—
—
Other
Enumeration date
10/25/2017
Last updated
10/25/2017
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