Healthcare Provider Details

I. General information

NPI: 1386893337
Provider Name (Legal Business Name): LIFE ST. FRANCIS CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2008
Last Update Date: 10/04/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7500 K JOHNSON BLVD
BORDENTOWN NJ
08505-2242
US

IV. Provider business mailing address

7500 K JOHNSON BLVD
BORDENTOWN NJ
08505-2242
US

V. Phone/Fax

Practice location:
  • Phone: 609-599-5433
  • Fax:
Mailing address:
  • Phone: 609-599-5433
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code302F00000X
TaxonomyExclusive Provider Organization
License Number
License Number State

VIII. Authorized Official

Name: MS. JILL ANN VIGGIANO
Title or Position: EXECUTIVE DIRECTOR
Credential: MS
Phone: 609-599-5475