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NPI Code Detail

MEDICARE: VIRTUA - MEMORIAL HOSPITAL BURLINGTON COUNTY, INC.

MEDICARE: VIRTUA - MEMORIAL HOSPITAL BURLINGTON COUNTY, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1282N00000XGeneral Acute Care Hospital10301NJ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
20053406OTHERNJHEALTHSTART

General Provider Information

NPI Number : 1134125016
Entity Type Code : Organization
Provider Name (Legal Business Name) : VIRTUA - MEMORIAL HOSPITAL BURLINGTON COUNTY, INC.
Provider Business Mailing Address
First Line : 406 LIPPINCOTT DR STE J
Second Line : ATTN: CHRISTINE GORDON
City : MARLTON
State : NJ
Zip : 08053-4168
Country : US
Telephone Number : 568-355-0655
Fax Number :
Provider Business Practice Location Address
First Line : 175 MADISON AVE
Second Line :
City : MOUNT HOLLY
State : NJ
Zip : 08060-2038
Country : US
Telephone Number : 609-267-0700
Fax Number :
Authorized Official
Title or Position : VP FOR FINANCE
Name : MR. GERRY LOWE
Credential :
Telephone Number : 856-355-0604
Provider Enumeration Date : 06/24/2005
Last Update Date : 04/15/2025

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