Healthcare Provider Details

I. General information

NPI: 1316070477
Provider Name (Legal Business Name): COUNTY OF GLOUCESTER, DEPT OF SENIOR SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2007
Last Update Date: 07/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 COUNTY HOUSE RD
SEWELL NJ
08080-2525
US

IV. Provider business mailing address

1 N BROAD ST PO BOX 337
WOODBURY NJ
08096-4602
US

V. Phone/Fax

Practice location:
  • Phone: 856-232-4646
  • Fax: 856-232-6709
Mailing address:
  • Phone: 856-853-3353
  • Fax: 856-845-6234

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. JEAN DUBOIS
Title or Position: COUNTY TREASURER
Credential:
Phone: 856-853-3353