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General NPI Number Information
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NPI Number | 1366533770
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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 | 09/28/2006
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Last Update Date | 12/10/2010
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Provider Practice Location Address
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Address Line | 300 MEDICAL CENTER DRIVE SUITE A
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City | SEWELL
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State | NJ
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Zip | 08080-2373
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Country | US
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Telephone | 856-218-4990
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Fax | 856-256-9624
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Provider Business Mailing Address
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Address Line | PO BOX 13703
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City | PHILADELPHIA
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State | PA
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Zip | 19101-3703
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Country | US
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Telephone | 856-661-5164
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Fax | 856-661-5274
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | MR. JOSEPH LARIO
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Credential |
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Telephone | 856-661-5144
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QE0700X
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Taxonomy Name | End-Stage Renal Disease (ESRD) Treatment Clinic/Center
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License Number | 1080
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License Number State | NJ
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