Healthcare Provider Details

I. General information

NPI: 1144592502
Provider Name (Legal Business Name): SOUTH JERSEY HEALTHCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/01/2012
Last Update Date: 02/01/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 TOMLIN STATION PARK SUITE D
MULLICA HILL NJ
08062
US

IV. Provider business mailing address

1430 W SHERMAN AVE
VINELAND NJ
08360-6927
US

V. Phone/Fax

Practice location:
  • Phone: 856-241-2533
  • Fax: 856-575-4988
Mailing address:
  • Phone: 856-641-7873
  • Fax: 856-692-6132

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number40QA00434800
License Number StateNJ

VIII. Authorized Official

Name: MS. DEBBIE MARIE FRANCESCHINI
Title or Position: SJH, DIRECTOR FOR REHABCARE
Credential: MS, PT, CLT
Phone: 856-641-7873