Healthcare Provider Details

I. General information

NPI: 1578555140
Provider Name (Legal Business Name): VIRTUA HEALTH & REHABILITATION CENTER AT BERLIN, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2005
Last Update Date: 04/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 LONG A COMING LN
BERLIN NJ
08009-1964
US

IV. Provider business mailing address

20 W. STOW RD. STE 8
MARLTON NJ
08053
US

V. Phone/Fax

Practice location:
  • Phone: 856-322-3684
  • Fax: 856-322-3601
Mailing address:
  • Phone: 856-355-0655
  • Fax: 856-355-0621

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number156001
License Number StateNJ

VIII. Authorized Official

Name: MR. DENNIS PULLIN
Title or Position: PRESIDENT/CEO
Credential:
Phone: 856-355-0004