Healthcare Provider Details

I. General information

NPI: 1306817978
Provider Name (Legal Business Name): SALEM HOSPITAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/31/2006
Last Update Date: 01/08/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 WOODSTOWN RD
SALEM NJ
08079-2064
US

IV. Provider business mailing address

PO BOX 503899
SAINT LOUIS MO
63150-3899
US

V. Phone/Fax

Practice location:
  • Phone: 856-935-1000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number71702
License Number StateNJ

VIII. Authorized Official

Name: PAULA LALOR
Title or Position: DIRECTOR/DELEGATED OFFICIAL
Credential:
Phone: 615-925-4565