Organization
WARREN MEDICAL SERVICES, INC.
Active
Other names
Stateline Medical
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GARY DAVID GAVORNIK (EXECUTIVE DIRECTOR)
(908) 387-0003
Entity
Organization
Contact information
Practice address
590 MARSHALL ST, PHILLIPSBURG, NJ 08865-2629
(908) 387-0003
(908) 387-0005
Mailing address
590 MARSHALL ST, PHILLIPSBURG, NJ 08865-2629
(908) 387-0003
(908) 387-0005
Taxonomy
Speciality
Code
Description
License number
State
261QM2800X
Methadone Clinic
Primary
22481
NJ
Other
Enumeration date
04/04/2007
Last updated
08/22/2020
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