Provider Demographics
NPI:1699064154
Name:MED PREP CONSULTING INC
Entity type:Organization
Organization Name:MED PREP CONSULTING INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:KALINOSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-493-3390
Mailing Address - Street 1:1540 W PARK AVE
Mailing Address - Street 2:SUITE 5
Mailing Address - City:OCEAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07712-3191
Mailing Address - Country:US
Mailing Address - Phone:732-493-3390
Mailing Address - Fax:732-493-3380
Practice Address - Street 1:1540 W PARK AVE
Practice Address - Street 2:SUITE 5
Practice Address - City:OCEAN
Practice Address - State:NJ
Practice Address - Zip Code:07712-3191
Practice Address - Country:US
Practice Address - Phone:732-493-3390
Practice Address - Fax:732-493-3380
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-05
Last Update Date:2011-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RS006154003336C0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
3197779OtherNCPDP PROVIDER IDENTIFICATION NUMBER