Cranford Family Practice

Primary specialty

Non-Pharmacy Dispensing SiteTaxonomy code 332900000X

License

MD417016 Issued in NJ

Legal business name

CRANFORD FAMILY PRACTICE

Practice address

570 South Ave E
Building G-Unit
Cranford, NJ 07016-3200

Phone

(908) 272-7970

NPI assigned

Aug 25, 2011

Last updated

Jan 30, 2015By the provider in NPPES

Organization subpart

Yes

Parent organization

MEDVANTX, INC.As reported in NPPES

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

Authorized official

Name

Kenny Heine

Title

VP of Operations

Phone

(858) 625-2990

Specialties & licenses 1

Addresses

Part of

Medvantx Inc

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

{
    "created_epoch": "1314230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1422576000000",
    "number": "1194005876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5626 OBERLIN DR",
            "address_2": "SUITE 110",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921211705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "570 SOUTH AVE E",
            "address_2": "BUILDING G-UNIT",
            "city": "CRANFORD",
            "state": "NJ",
            "postal_code": "070163200",
            "telephone_number": "908-272-7970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRANFORD FAMILY PRACTICE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEDVANTX, INC.",
        "enumeration_date": "2011-08-25",
        "last_updated": "2015-01-30",
        "status": "A",
        "authorized_official_last_name": "HEINE",
        "authorized_official_first_name": "KENNY",
        "authorized_official_title_or_position": "VP OF OPERATIONS",
        "authorized_official_telephone_number": "858-625-2990"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "NJ",
            "license": "MD417016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Non-Pharmacy Dispensing Site in Cranford, NJ
• Providers in Cranford, NJ by specialty
• Non-Pharmacy Dispensing Site in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.