Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Stafford Medical PA

Organization Non-Pharmacy Dispensing Site · NPI 1093052102

Stafford Medical PA is a Non-Pharmacy Dispensing Site in Manahawkin, New Jersey. Licensed in New Jersey. Registered with an NPI since 2013.

Licensed in
NJ
In the registry since
2013
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1364 Route 72 W 2
Manahawkin, NJ 08050-2485
Phone: (609) 597-3416
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Non-Pharmacy Dispensing Site (primary) Taxonomy 332900000X · Licence 25MA066536 (NJ)

Record details

NPI number1093052102
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationMedvantx Inc
Authorized official Kenny Heine — Vp Ops · (858) 964-1506
NPI enumeratedJanuary 9, 2013
Last updated in NPPESJanuary 9, 2013
Mailing address5626 Oberlin Dr, 110, San Diego, CA 92121-1705

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