| Jl Hudson Holdings Llc | |
|
1217 Calhoun Street Trenton NJ 08638-4015 | |
| (973) 868-0615 | |
| Not Available |
| Full Name | Jl Hudson Holdings Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1217 Calhoun Street, Trenton, New Jersey |
| Authorized Official Name and Position | Sampson M Davis (AUTHORIZED MEMBER) |
| Authorized Official Contact | 9738680615 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jl Hudson Holdings Llc 350 Harding Dr South Orange NJ 07079-1339 Ph: (973) 868-0615 | Jl Hudson Holdings Llc 1217 Calhoun Street Trenton NJ 08638-4015 Ph: (973) 868-0615 |
| NPI Number | 1205425030 |
|---|---|
| Provider Enumeration Date | 01/15/2021 |
| Last Update Date | 06/06/2022 |
| Medicare PECOS PAC ID | 2062827637 |
|---|---|
| Medicare Enrollment ID | O20210211001516 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205425030 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Sampson M Davis |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1346242310 PECOS PAC ID: 7012963218 Enrollment ID: I20210211002206 |
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