NPIMap

Organization Active NPI

First Care Medical Group Inc

Doing business as First Care Medical Group- Lyndhurst

  • Non-Pharmacy Dispensing Site
  • Lyndhurst, NJ
National Provider Identifier
1619218542
Registry record updated Mar 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
License
25MA04732500 Issued in NJ
Legal business name
FIRST CARE MEDICAL GROUP INC
Doing business as
First Care Medical Group- Lyndhurst
Practice address
750 Valley Brook Ave
Lyndhurst, NJ 07071-1301
Phone
(201) 896-0900
NPI assigned
Mar 1, 2013
Last updated
Mar 1, 2013By the provider in NPPES
Organization subpart
Yes
Parent organization
MEDVANTX, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 1, 2013

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

Authorized official

Name
Kenny Heine
Title
VP Ops
Phone
(858) 964-1506

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X 25MA04732500 NJ Primary

Addresses

Primary practice location

750 Valley Brook Ave
Lyndhurst, NJ 07071-1301

Mailing address

5626 Oberlin Dr
Suite 110
San Diego, CA 92121-1705

Other names 1

  • FIRST CARE MEDICAL GROUP- LYNDHURST Doing business as

National Provider Directory

National Provider Directory
Tax ID family
First Care Medical Group Inc4 organizations share this tax ID, including this one
Part of
Medvantx Inc

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1362096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1362096000000",
    "number": "1619218542",
    "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": "750 VALLEY BROOK AVE",
            "city": "LYNDHURST",
            "state": "NJ",
            "postal_code": "070711301",
            "telephone_number": "201-896-0900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIRST CARE MEDICAL GROUP INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEDVANTX, INC.",
        "enumeration_date": "2013-03-01",
        "last_updated": "2013-03-01",
        "status": "A",
        "authorized_official_last_name": "HEINE",
        "authorized_official_first_name": "KENNY",
        "authorized_official_title_or_position": "VP OPS",
        "authorized_official_telephone_number": "858-964-1506"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "NJ",
            "license": "25MA04732500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FIRST CARE MEDICAL GROUP- LYNDHURST",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lyndhurst, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2013; 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.