Healthcare Provider Details

I. General information

NPI: 1629041603
Provider Name (Legal Business Name): COUNTY OF BURLINGTON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/09/2006
Last Update Date: 08/21/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 PEMBERTON-BROWNS MILLS ROAD
NEW LISBON NJ
08064
US

IV. Provider business mailing address

PO BOX 6000
MOUNT HOLLY NJ
08060-6000
US

V. Phone/Fax

Practice location:
  • Phone: 609-726-7000
  • Fax: 609-726-1753
Mailing address:
  • Phone: 609-726-7000
  • Fax: 609-726-1753

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number060302
License Number StateNJ

VIII. Authorized Official

Name: MS. EVE A CULLINAN
Title or Position: ADMINISTRATOR
Credential: LNHA
Phone: 609-726-7000