Provider Demographics
NPI:1003261934
Name:LRX OF SOUTH JERSEY, LLC
Entity Type:Organization
Organization Name:LRX OF SOUTH JERSEY, LLC
Other - Org Name:LEARNINGRX CHERRY HILL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:PEARSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-348-3600
Mailing Address - Street 1:801 ROUTE 73 N
Mailing Address - Street 2:SUITE E
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-1282
Mailing Address - Country:US
Mailing Address - Phone:856-348-3600
Mailing Address - Fax:856-348-3602
Practice Address - Street 1:801 ROUTE 73 N
Practice Address - Street 2:SUITE E
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053-1282
Practice Address - Country:US
Practice Address - Phone:856-348-3600
Practice Address - Fax:856-348-3602
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-28
Last Update Date:2016-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation PractitionerGroup - Single Specialty
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental HealthGroup - Single Specialty