Clayton Adaptive Rehab Equipment, Inc

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

License

0079490 Issued in NJ

Legal business name

CLAYTON ADAPTIVE REHAB EQUIPMENT, INC

Practice address

125 S Black Horse Pike
Blackwood, NJ 08012-2954

Phone

(856) 401-8822

Fax

(856) 401-8833

NPI assigned

Aug 31, 2006

Organization subpart

No

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

Authorized official

Name

Russ Entrekin

Title

President

Phone

(856) 401-8822

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1497867055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 S BLACK HORSE PIKE",
            "city": "BLACKWOOD",
            "state": "NJ",
            "postal_code": "080122954",
            "telephone_number": "856-401-8822",
            "fax_number": "856-401-8833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 S BLACK HORSE PIKE",
            "city": "BLACKWOOD",
            "state": "NJ",
            "postal_code": "080122954",
            "telephone_number": "856-401-8822",
            "fax_number": "856-401-8833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLAYTON ADAPTIVE REHAB EQUIPMENT, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ENTREKIN",
        "authorized_official_first_name": "RUSS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "856-401-8822"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "NJ",
            "license": "0079490",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3460801",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Customized Equipment (DME) in Blackwood, NJ
• Providers in Blackwood, NJ by specialty
• Customized Equipment (DME) in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.