Healthcare Provider Details
I. General information
NPI: 1568868602
Provider Name (Legal Business Name): INSPIRA MEDICAL CENTER WOODBURY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/18/2014
Last Update Date: 11/18/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
509 N BROAD ST
WOODBURY NJ
08096-1617
US
IV. Provider business mailing address
509 N BROAD ST
WOODBURY NJ
08096-1617
US
V. Phone/Fax
- Phone: 856-853-2084
- Fax:
- Phone: 856-853-2084
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 333300000X |
| Taxonomy | Emergency Response System Companies |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
JAMES
THOMAS
O'CONNELL
Title or Position: DIRECTOR REVENUE CYCLE
Credential: CPA
Phone: 856-575-4777