MEDICARE: KENNEDY UNIVERSITY HOSPITAL, INC

Medicare Provider Information

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency	22365	NJ

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
3	317073	OTHER	RAILROAD MEDICARE
8	317073	OTHER	MEDICARE PART B
9	317073	OTHER	HORIZON MEDICARE POS

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	317073	OTHER	HORIZON HMO
5	317073	OTHER	HORIZON PPO BLUE SELECT
6	317073	OTHER	HORIZON PPO BLUE CHOICE
7	2K1918	OTHER	HEALTHNET
10	317073	OTHER	HORIZON NJ PLUS
11	317073	OTHER	HORIZON HMO BLUE
12	317073	OTHER	COMPSOURCE
13	317073	OTHER	HORIZON POS
14	317073	OTHER	HORIZON BLUE CARD PPO

NPI Number	:	1083606164
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KENNEDY UNIVERSITY HOSPITAL, INC

Provider Business Mailing Address
First Line	:	333 LAUREL OAK ROAD
Second Line	:	UNIT D
City	:	VOORHEES
State	:	NJ
Zip	:	08043
Country	:	US
Telephone Number	:	856-809-4300
Fax Number	:	856-566-9455

Provider Business Practice Location Address
First Line	:	1099 WHITE HORSE RD
Second Line	:
City	:	VOORHEES
State	:	NJ
Zip	:	08043-4405
Country	:	US
Telephone Number	:	856-566-2000
Fax Number	:	856-566-5288

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MRS. KATHLEEN D. FLANNERY
Credential	:	RN
Telephone Number	:	856-809-4331

Provider Enumeration Date	:	08/16/2005
Last Update Date	:	05/08/2019

1099 WHITE HORSE RD STE 232
VOORHEES, NJ
08043-4405

Practice Phone: 732-520-8877
Practice Fax: 732-526-6574