Healthcare Provider Details

I. General information

NPI: 1467440743
Provider Name (Legal Business Name): DEBORAH HEART AND LUNG CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2005
Last Update Date: 09/07/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 TRENTON RD
BROWNS MILLS NJ
08015-1705
US

IV. Provider business mailing address

200 TRENTON RD
BROWNS MILLS NJ
08015-1705
US

V. Phone/Fax

Practice location:
  • Phone: 609-893-1200
  • Fax: 609-735-0175
Mailing address:
  • Phone: 609-893-1200
  • Fax: 609-735-0175

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number20301
License Number StateNJ

VIII. Authorized Official

Name: MR. JOSEPH CHIRICHELLA
Title or Position: PRESIDENT AND CEO
Credential:
Phone: 609-893-1200