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General NPI Number Information
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NPI Number | 1629055694
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Entity Type | Organization
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Legal Business Name | INSPIRA MEDICAL CENTER WOODBURY, INC.
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Dates
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Enumeration Date | 12/29/2005
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Last Update Date | 05/16/2014
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Provider Practice Location Address
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Address Line | 509 N BROAD ST
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City | WOODBURY
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State | NJ
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Zip | 08096-1617
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Country | US
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Telephone | 856-845-0100
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Fax | 856-384-1358
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Provider Business Mailing Address
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Address Line | 509 N BROAD ST
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City | WOODBURY
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State | NJ
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Zip | 08096-1617
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Country | US
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Telephone | 856-845-0100
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Fax | 856-384-1358
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Authorized Official
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Title or Position | VICE PRESIDENT COO
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Name | MR. JOHN GRAHAM
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Credential |
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Telephone | 856-845-0100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 273R00000X
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Taxonomy Name | Psychiatric Hospital Unit
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License Number | 31S081
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 283Q00000X
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Taxonomy Name | Psychiatric Hospital
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License Number | 10801
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License Number State | NJ
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