Provider Demographics
NPI:1710765391
Name:LOCAL INFUSION HEALTH OF NJ PC
Entity type:Organization
Organization Name:LOCAL INFUSION HEALTH OF NJ PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:WOODRUFF
Authorized Official - Middle Name:HALL
Authorized Official - Last Name:BAUM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:844-509-1404
Mailing Address - Street 1:PO BOX 53303
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85072-3303
Mailing Address - Country:US
Mailing Address - Phone:844-614-2354
Mailing Address - Fax:844-278-8635
Practice Address - Street 1:433 OLD HOOK RD UNIT 4
Practice Address - Street 2:
Practice Address - City:EMERSON
Practice Address - State:NJ
Practice Address - Zip Code:07630-1323
Practice Address - Country:US
Practice Address - Phone:844-509-1404
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-15
Last Update Date:2025-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty
No261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion TherapyGroup - Multi-Specialty