Healthcare Provider Details

I. General information

NPI: 1336141266
Provider Name (Legal Business Name): MOORESTOWN VISITING NURSE ASSOCIATION INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2005
Last Update Date: 06/13/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 HARPER DR
MOORESTOWN NJ
08057-3208
US

IV. Provider business mailing address

300 HARPER DR
MOORESTOWN NJ
08057-3208
US

V. Phone/Fax

Practice location:
  • Phone: 856-552-1300
  • Fax: 856-552-1314
Mailing address:
  • Phone: 856-552-1300
  • Fax: 856-552-1314

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number23035
License Number StateNJ

VIII. Authorized Official

Name: MS. KATHLEEN A MILLER
Title or Position: CFO
Credential:
Phone: 856-552-1300