Healthcare Provider Details

I. General information

NPI: 1346579463
Provider Name (Legal Business Name): KENNEDY MEMORIAL HOSPITALS - UNIVERSITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2009
Last Update Date: 12/19/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18 E LAUREL RD
STRATFORD NJ
08084-1327
US

IV. Provider business mailing address

500 MARLBORO AVE
CHERRY HILL NJ
08002-2020
US

V. Phone/Fax

Practice location:
  • Phone: 856-346-7319
  • Fax: 856-346-6476
Mailing address:
  • Phone: 856-661-5350
  • Fax: 856-661-5244

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336I0012X
TaxonomyInstitutional Pharmacy
License Number28RS00397200
License Number StateNJ

VIII. Authorized Official

Name: JOSEPH LARIO
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 856-661-5350