MEDICARE: SOUTHERN JERSEY FAMILY MEDICAL CENTERS, INC

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	261QF0400X	Federally Qualified Health Center (FQHC)	24035	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1265557326
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUTHERN JERSEY FAMILY MEDICAL CENTERS, INC

Provider Business Mailing Address
First Line	:	1 EXECUTIVE DR STE 400
Second Line	:
City	:	MARLTON
State	:	NJ
Zip	:	08053-4278
Country	:	US
Telephone Number	:	609-567-0434
Fax Number	:	609-704-5615

Provider Business Practice Location Address
First Line	:	651 HIGH ST
Second Line	:
City	:	BURLINGTON CITY
State	:	NJ
Zip	:	08016-2737
Country	:	US
Telephone Number	:	609-386-0775
Fax Number	:	609-386-4372

Authorized Official
Title or Position	:	PRESIDENT/CEO, INTERIM
Name	:	ESTHER WILLIAMS CARPENTER
Credential	:
Telephone Number	:	609-567-0434

Provider Enumeration Date	:	03/20/2007
Last Update Date	:	05/05/2026

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