Provider Demographics
NPI:1235137282
Name:VIRTUA MEMORIAL HOSPITAL OF BURLINGTON COUNTY
Entity Type:Organization
Organization Name:VIRTUA MEMORIAL HOSPITAL OF BURLINGTON COUNTY
Other - Org Name:VIRTUA REHAB NETWORK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMIN. SECRETARY
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:A
Authorized Official - Last Name:ENGELKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-914-8482
Mailing Address - Street 1:175 MADISON AVE
Mailing Address - Street 2:1636 ROUTE 38 AND EAYRESTOWN ROAD
Mailing Address - City:MOUNT HOLLY
Mailing Address - State:NJ
Mailing Address - Zip Code:08060-2038
Mailing Address - Country:US
Mailing Address - Phone:609-914-8482
Mailing Address - Fax:609-914-8485
Practice Address - Street 1:1636 ROUTE 38
Practice Address - Street 2:VIRTUA REHAB NETWORK
Practice Address - City:LUMBERTON
Practice Address - State:NJ
Practice Address - Zip Code:08048-2900
Practice Address - Country:US
Practice Address - Phone:609-914-8482
Practice Address - Fax:609-914-8485
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ273Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273Y00000XHospital UnitsRehabilitation Unit