MEDICARE: ACENDA, 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
1	261QC1500X	Community Health Clinic/Center

General Provider Information

NPI Number	:	1649044355
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ACENDA, INC.

Provider Business Mailing Address
First Line	:	42 DELSEA DR S
Second Line	:
City	:	GLASSBORO
State	:	NJ
Zip	:	08028-2621
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3322 COLLEGE DR BLDG 11
Second Line	:
City	:	VINELAND
State	:	NJ
Zip	:	08360-6926
Country	:	US
Telephone Number	:	844-422-3632
Fax Number	:

Authorized Official
Title or Position	:	CFO & TREASURER
Name	:	JEREMY P WAMPLER
Credential	:	CPA
Telephone Number	:	844-422-3632

Provider Enumeration Date	:	11/13/2023
Last Update Date	:	03/18/2024

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Directions to “ACENDA, INC. ” Practice Location

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