MEDICARE: ATLANTICARE HEALTH SERVICES, 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	251G00000X	Community Based Hospice Care Agency	22853	NJ

Other Identifiers

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

General Provider Information

NPI Number	:	1699760157
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ATLANTICARE HEALTH SERVICES, INC.

Provider Business Mailing Address
First Line	:	6550 DELILAH RD
Second Line	:	SUITE 210
City	:	EGG HARBOR TWP
State	:	NJ
Zip	:	08234-5142
Country	:	US
Telephone Number	:	609-407-2020
Fax Number	:	609-407-2021

Provider Business Practice Location Address
First Line	:	6550 DELILAH RD.
Second Line	:	SUITE 210
City	:	EGG HARBOR TWP
State	:	NJ
Zip	:	08234-5142
Country	:	US
Telephone Number	:	609-407-2020
Fax Number	:	609-407-2021

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MRS. DEBRA MEREDITH
Credential	:
Telephone Number	:	609-407-2020

Provider Enumeration Date	:	09/12/2005
Last Update Date	:	01/07/2011

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