Healthcare Provider Details

I. General information

NPI: 1245262757
Provider Name (Legal Business Name): ATLANTICARE REGIONAL MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 02/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1925 PACIFIC AVE
ATLANTIC CITY NJ
08401-6713
US

IV. Provider business mailing address

65 W JIMMIE LEEDS RD
POMONA NJ
08240-9102
US

V. Phone/Fax

Practice location:
  • Phone: 609-344-4081
  • Fax:
Mailing address:
  • Phone: 609-652-1000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code284300000X
TaxonomySpecial Hospital
License Number10102
License Number StateNJ

VIII. Authorized Official

Name: MR. WALTER GREINER
Title or Position: VP FINANCE & CHIEF FINANCIAL OFFICE
Credential:
Phone: 609-272-2434