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General NPI Number Information
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NPI Number | 1710930102
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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 | 05/18/2006
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Last Update Date | 09/13/2007
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Provider Practice Location Address
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Address Line | 65 JIMIE LEEDS ROAD
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City | POMONA
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State | NJ
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Zip | 08240
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Country | US
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Telephone | 609-652-3444
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Fax |
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Provider Business Mailing Address
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Address Line | 255 W MICHIGAN AVE
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City | JACKSON
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State | MI
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Zip | 49201-2218
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Country | US
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Telephone | 517-787-6440
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Fax | 517-787-4146
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Authorized Official
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Title or Position | CFO
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Name | WALTER GREINER
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Credential |
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Telephone | 609-652-3444
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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