MEDICARE: FOOT HEALTH CENTERS, P.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213E00000X	Podiatrist		NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1067235	OTHER	NJ	HORIZON NJ HEALTH
2	0421600000	OTHER	NJ	AMERIHEALTH
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1013020387
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FOOT HEALTH CENTERS, P.A.

Provider Business Mailing Address
First Line	:	52 BERLIN RD
Second Line	:	SUITE 5000
City	:	CHERRY HILL
State	:	NJ
Zip	:	08034-3574
Country	:	US
Telephone Number	:	856-795-1003
Fax Number	:	856-795-5994

Provider Business Practice Location Address
First Line	:	1113 HOSPITAL DR
Second Line	:	BLD E., SUITE 106
City	:	WILLINGBORO
State	:	NJ
Zip	:	08046-1103
Country	:	US
Telephone Number	:	609-877-4860
Fax Number	:	856-795-5994

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	JANINE COTTRILL
Credential	:
Telephone Number	:	856-795-1003

Provider Enumeration Date	:	08/17/2006
Last Update Date	:	12/14/2007

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Directions to “FOOT HEALTH CENTERS, P.A. ” Practice Location

Language	Start Address	Practice Location

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