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General NPI Number Information
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NPI Number | 1093053738
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Entity Type | Organization
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Legal Business Name | FAMCARE, INC
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Dates
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Enumeration Date | 01/30/2013
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Last Update Date | 12/12/2014
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Provider Practice Location Address
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Address Line | 30 MAGNOLIA AVE
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City | BRIDGETON
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State | NJ
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Zip | 08302-1721
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Country | US
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Telephone | 856-451-8098
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Fax | 856-451-8406
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Provider Business Mailing Address
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Address Line | 711 N MAIN ST
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City | GLASSBORO
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State | NJ
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Zip | 08028-1639
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Country | US
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Telephone | 856-881-6117
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Fax | 856-863-2816
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Authorized Official
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Title or Position | CONSULTANT
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Name | SABRINA E CANNADY
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Credential | CPC
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Telephone | 856-467-9344
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0005X
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Taxonomy Name | Ambulatory Family Planning Facility
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License Number | 70691
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | 70691
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License Number State | NJ
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