Organization Active NPI

Township of Randolph

  • Public Health or Welfare Agency
  • Randolph, NJ
National Provider Identifier
1114109360
Registry record updated Jul 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health or Welfare AgencyTaxonomy code 251K00000X
License
251K00000X Issued in NJ
Legal business name
TOWNSHIP OF RANDOLPH
Practice address
502 Millbrook Ave
Randolph, NJ 07869-3702
Phone
(973) 989-7050
Fax
(973) 989-0762
NPI assigned
Nov 29, 2007
Last updated
Jul 24, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Mark Caputo, HEALTH OFFICER
Title
Health Officer
Phone
(973) 989-7050

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health or Welfare Agency 251K00000X 251K00000X NJ Primary

Addresses

Primary practice location

502 Millbrook Ave
Randolph, NJ 07869-3702

Mailing address

502 Millbrook Ave
Randolph, NJ 07869-3702
Phone (973) 989-7050

Other names 1

  • Township of Randolph Health Department Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081202000615 NJ Part B Supplier - Mass Immunization (Roster Biller Only) 8628137999 Practice locations: Randolph, NJ

National Provider Directory

National Provider Directory

Locations

502 Millbrook Ave
Randolph, NJ 07869
Phone (973) 989-7050

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1196294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216857600000",
    "number": "1114109360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "502 MILLBROOK AVE",
            "city": "RANDOLPH",
            "state": "NJ",
            "postal_code": "078693702",
            "telephone_number": "973-989-7050",
            "fax_number": "973-989-0762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 MILLBROOK AVE",
            "city": "RANDOLPH",
            "state": "NJ",
            "postal_code": "078693702",
            "telephone_number": "973-989-7050",
            "fax_number": "973-989-0762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOWNSHIP OF RANDOLPH",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-29",
        "last_updated": "2008-07-24",
        "status": "A",
        "authorized_official_last_name": "CAPUTO",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "HEALTH OFFICER",
        "authorized_official_telephone_number": "973-989-7050",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "HEALTH OFFICER"
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "NJ",
            "license": "251K00000X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Township of Randolph Health Department",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Randolph, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.