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General NPI Number Information
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NPI Number | 1083606164
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Entity Type | Organization
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Legal Business Name | KENNEDY UNIVERSITY HOSPITAL, INC
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Dates
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Enumeration Date | 08/16/2005
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Last Update Date | 05/08/2019
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Provider Practice Location Address
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Address Line | 1099 WHITE HORSE RD
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City | VOORHEES
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State | NJ
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Zip | 08043-4405
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Country | US
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Telephone | 856-566-2000
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Fax | 856-566-5288
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Provider Business Mailing Address
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Address Line | 333 LAUREL OAK ROAD UNIT D
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City | VOORHEES
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State | NJ
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Zip | 08043
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Country | US
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Telephone | 856-809-4300
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Fax | 856-566-9455
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. KATHLEEN D. FLANNERY
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Credential | RN
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Telephone | 856-809-4331
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 22365
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License Number State | NJ
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