Healthcare Provider Details

I. General information

NPI: 1407617947
Provider Name (Legal Business Name): ATLANTICARE HEALTH SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2024
Last Update Date: 01/22/2024
Certification Date: 01/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 ENGLISH CREEK AVE STE 601
EGG HARBOR TOWNSHIP NJ
08234-5588
US

IV. Provider business mailing address

1401 ATLANTIC AVE STE 1125
ATLANTIC CITY NJ
08401-7001
US

V. Phone/Fax

Practice location:
  • Phone: 609-833-9925
  • Fax:
Mailing address:
  • Phone: 609-572-6006
  • Fax: 609-572-6001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QI0500X
TaxonomyInfusion Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. CHRISTOPHER CARL APGAR
Title or Position: DIRECTOR OF FINANCE
Credential:
Phone: 609-572-6006