1578943536 NPI number — ARC OF CAMDEN COUNTY - VOORHEES GH

Table of content: (NPI 1578943536)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1578943536 NPI number — ARC OF CAMDEN COUNTY - VOORHEES GH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ARC OF CAMDEN COUNTY - VOORHEES GH
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:
Provider Other Organization Name Type Code:
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:
1578943536
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/04/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
215 W WHITE HORSE PIKE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BERLIN
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08009-1132
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
856-767-3650
Provider Business Mailing Address Fax Number:
856-767-6110

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
904 RURAL AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
VOORHEES
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08043-2265
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
856-428-0175
Provider Business Practice Location Address Fax Number:
856-428-0976
Provider Enumeration Date:
06/04/2015

Additional Information

Authorized Official

Authorized Official Last Name:
ENGLEBERT
Authorized Official First Name:
MARGARET
Authorized Official Middle Name:
M.
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
856-767-3650

Provider Taxonomy Codes

  • Taxonomy code: 253Z00000X , with the licence number:  GH1037 , 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)





Copyright © 2007-2025 www.npivalidator.com