Healthcare Provider Details

I. General information

NPI: 1952478885
Provider Name (Legal Business Name): ATLANTICARE SURGERY CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/29/2006
Last Update Date: 02/06/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

798 ROUTE 539 BUILDING A SUITE 1
LITTLE EGG HARBOR TWP NJ
08087-4203
US

IV. Provider business mailing address

798 ROUTE 539 BUILDING A SUITE 1
LITTLE EGG HARBOR NJ
08087
US

V. Phone/Fax

Practice location:
  • Phone: 609-296-1122
  • Fax: 609-296-1142
Mailing address:
  • Phone: 609-296-1122
  • Fax: 609-296-1142

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. KIMBERLY ANN KIRK
Title or Position: DIRECTOR OF FINANCE
Credential:
Phone: 609-407-2553