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General NPI Number Information
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NPI Number | 1386746592
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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 | 09/01/2006
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Last Update Date | 04/22/2025
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Provider Practice Location Address
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Address Line | 18 E LAUREL RD
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City | STRATFORD
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State | NJ
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Zip | 08084-1327
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Country | US
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Telephone | 856-346-6000
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Fax | 856-346-6005
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Provider Business Mailing Address
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Address Line | PO BOX 787032
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City | PHILADELPHIA
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State | PA
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Zip | 19178-7032
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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 | REGIONAL CFO
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Name | TIMOTHY MACCRACKEN
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Credential |
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Telephone | 215-481-2853
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QE0002X
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Taxonomy Name | Emergency Care Clinic/Center
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License Number | 10403
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 10403
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License Number State | NJ
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