Healthcare Provider Details

I. General information

NPI: 1235137282
Provider Name (Legal Business Name): VIRTUA MEMORIAL HOSPITAL OF BURLINGTON COUNTY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2005
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1636 ROUTE 38 VIRTUA REHAB NETWORK
LUMBERTON NJ
08048-2900
US

IV. Provider business mailing address

175 MADISON AVE 1636 ROUTE 38 AND EAYRESTOWN ROAD
MOUNT HOLLY NJ
08060-2038
US

V. Phone/Fax

Practice location:
  • Phone: 609-914-8482
  • Fax: 609-914-8485
Mailing address:
  • Phone: 609-914-8482
  • Fax: 609-914-8485

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273Y00000X
TaxonomyRehabilitation Hospital Unit
License Number
License Number StateNJ

VIII. Authorized Official

Name: MRS. DEBRA A ENGELKE
Title or Position: ADMIN. SECRETARY
Credential:
Phone: 609-914-8482