Healthcare Provider Details

I. General information

NPI: 1154530624
Provider Name (Legal Business Name): GENERAL HEALTHCARERESORCES,INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 N NEW YORK AVE A
ATLANTIC CITY NJ
08401-4463
US

IV. Provider business mailing address

215 NEW YORK AVE. A
ATLANTIC CITY NJ
08401-0840
US

V. Phone/Fax

Practice location:
  • Phone: 609-348-6479
  • Fax: 610-834-7525
Mailing address:
  • Phone: 609-348-6479
  • Fax: 610-834-7525

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number26NP03186100
License Number StateNJ

VIII. Authorized Official

Name: MS. ELLA M DEVANE I
Title or Position: LPN
Credential: NURSE
Phone: 609-348-6479