Healthcare Provider Details

I. General information

NPI: 1689393837
Provider Name (Legal Business Name): VIRTUA HOME CARE -COMMUNITY NURSING SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/23/2022
Last Update Date: 10/16/2023
Certification Date: 08/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 TOWNSEND AVE
BERLIN NJ
08009
US

IV. Provider business mailing address

100 TOWNSEND AVE
BERLIN NJ
08009
US

V. Phone/Fax

Practice location:
  • Phone: 856-322-3080
  • Fax: 856-322-3081
Mailing address:
  • Phone: 856-322-3080
  • Fax: 856-322-3081

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: DR. JOHN MARK MATSINGER
Title or Position: PRESIDENT/VIRTUA HOME CARE-COMMUNIT
Credential: D.O.
Phone: 856-355-0003