Provider Demographics
NPI:1386755411
Name:MURDOCH INC
Entity type:Organization
Organization Name:MURDOCH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:MURDOCH
Authorized Official - Suffix:
Authorized Official - Credentials:CO CPED BOCO
Authorized Official - Phone:973-748-6484
Mailing Address - Street 1:623 BLOOMFIELD AVENUE
Mailing Address - Street 2:PO BOX 505
Mailing Address - City:BLOOMFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07003
Mailing Address - Country:US
Mailing Address - Phone:973-748-5484
Mailing Address - Fax:973-748-3466
Practice Address - Street 1:623 BLOOMFIELD AVE
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07003
Practice Address - Country:US
Practice Address - Phone:973-748-6484
Practice Address - Fax:973-748-3466
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ450R00006500335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ01000336700OtherAMERICHOICE
0531695OtherAETNA
NJ1013944OtherHORIZON NJ HEALTH
NJ1628101Medicaid
55005OtherA,MERIGROUP
NJ1628101Medicaid