Provider Demographics
NPI:1003282153
Name:ROWAN WELLNESS CENTER - FAMILY MEDICINE
Entity Type:Organization
Organization Name:ROWAN WELLNESS CENTER - FAMILY MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT OF FINANCE & CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:F
Authorized Official - Last Name:SCULLY
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:856-256-4127
Mailing Address - Street 1:201 MULLICA HILL RD
Mailing Address - Street 2:WINANS HALL
Mailing Address - City:GLASSBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08028-1700
Mailing Address - Country:US
Mailing Address - Phone:856-256-4333
Mailing Address - Fax:856-256-4427
Practice Address - Street 1:201 MULLICA HILL RD
Practice Address - Street 2:WINANS HALL
Practice Address - City:GLASSBORO
Practice Address - State:NJ
Practice Address - Zip Code:08028-1700
Practice Address - Country:US
Practice Address - Phone:856-256-4333
Practice Address - Fax:856-256-4427
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-12
Last Update Date:2015-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty