1497704845 NPI number — ATLANTICARE HEALTH SERVICES, INC.

Table of content: (NPI 1497704845)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497704845 NPI number — ATLANTICARE HEALTH SERVICES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ATLANTICARE HEALTH SERVICES, INC.
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:
ATLANTICARE HEALTH SERVICES - COVENANT HOUSE
Provider Other Organization Name Type Code:
5
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:
1497704845
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/09/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1401 ATLANTIC AVE STE 1125
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ATLANTIC CITY
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08401-7001
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
609-572-6002
Provider Business Mailing Address Fax Number:
609-572-6001

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
929 ATLANTIC AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ATLANTIC CITY
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08401
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
609-348-4070
Provider Business Practice Location Address Fax Number:
609-348-1122
Provider Enumeration Date:
05/10/2006

Additional Information

Authorized Official

Authorized Official Last Name:
APGAR
Authorized Official First Name:
CHRISTOPHER
Authorized Official Middle Name:
CARL
Authorized Official Title or Position:
DIRECTOR OF FINANCE/CFO
Authorized Official Telephone Number:
609-572-6006

Provider Taxonomy Codes

  • Taxonomy code: 261Q00000X , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QF0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2024 www.npivalidator.com