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General NPI Number Information
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NPI Number | 1235677378
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Entity Type | Organization
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Legal Business Name | ATLANTICARE REGIONAL MEDICAL CENTER
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Dates
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Enumeration Date | 02/09/2017
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Last Update Date | 02/09/2017
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Provider Practice Location Address
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Address Line | 1925 PACIFIC AVE
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City | ATLANTIC CITY
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State | NJ
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Zip | 08401-6713
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Country | US
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Telephone | 609-572-8599
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Fax | 609-572-8598
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Provider Business Mailing Address
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Address Line | 1925 PACIFIC AVE
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City | ATLANTIC CITY
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State | NJ
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Zip | 08401-6713
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Country | US
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Telephone | 609-572-8599
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Fax | 609-572-8598
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Authorized Official
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Title or Position | AVP PHARMACY/MEDICINE
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Name | SANDRA GARRETT
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Credential |
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Telephone | 609-449-4336
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 28RS00754100
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License Number State | NJ
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