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General NPI Number Information
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NPI Number | 1528024114
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Entity Type | Organization
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Legal Business Name | AMBULATORY CARE CENTER PA
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Dates
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Enumeration Date | 04/24/2006
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Last Update Date | 06/22/2023
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Provider Practice Location Address
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Address Line | 1133 EAST CHESTNUT AVE.
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City | VINELAND
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State | NJ
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Zip | 08360
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Country | US
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Telephone | 856-507-0800
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Fax | 856-507-0824
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Provider Business Mailing Address
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Address Line | 1133 EAST CHESTNUT AVE.
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City | VINELAND
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State | NJ
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Zip | 08360
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Country | US
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Telephone | 856-507-0800
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Fax | 856-507-0824
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MELISSA RITTER HERMANSON
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Credential |
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Telephone | 856-507-0800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | 22422
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State | NJ
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