1235137282 NPI number — VIRTUA MEMORIAL HOSPITAL OF BURLINGTON COUNTY

Table of content: (NPI 1235137282)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235137282 NPI number — VIRTUA MEMORIAL HOSPITAL OF BURLINGTON COUNTY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
VIRTUA MEMORIAL HOSPITAL OF BURLINGTON COUNTY
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
VIRTUA REHAB NETWORK
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1235137282
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
175 MADISON AVE
Provider Second Line Business Mailing Address:
1636 ROUTE 38 AND EAYRESTOWN ROAD
Provider Business Mailing Address City Name:
MOUNT HOLLY
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08060-2038
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
609-914-8482
Provider Business Mailing Address Fax Number:
609-914-8485

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1636 ROUTE 38
Provider Second Line Business Practice Location Address:
VIRTUA REHAB NETWORK
Provider Business Practice Location Address City Name:
LUMBERTON
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08048-2900
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
609-914-8482
Provider Business Practice Location Address Fax Number:
609-914-8485
Provider Enumeration Date:
07/13/2005

Additional Information

Authorized Official

Authorized Official Last Name:
ENGELKE
Authorized Official First Name:
DEBRA
Authorized Official Middle Name:
A
Authorized Official Title or Position:
ADMIN. SECRETARY
Authorized Official Telephone Number:
609-914-8482

Provider Taxonomy Codes

  • Taxonomy code: 273Y00000X , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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