Provider Demographics
NPI:1295838126
Name:JERSEY SHORE UNIVERSITY MEDICAL CENTER
Entity Type:Organization
Organization Name:JERSEY SHORE UNIVERSITY MEDICAL CENTER
Other - Org Name:MERIDIAN BEHAVIORAL HEALTH
Other - Org Type:Other Name
Authorized Official - Title/Position:STAFF NURSE
Authorized Official - Prefix:
Authorized Official - First Name:MAUREEN
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:O'ROURKE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:732-776-2325
Mailing Address - Street 1:73-1ST AVE.
Mailing Address - Street 2:APT. B
Mailing Address - City:ATLANTIC HIGHLANDS
Mailing Address - State:NJ
Mailing Address - Zip Code:07716
Mailing Address - Country:US
Mailing Address - Phone:732-291-4235
Mailing Address - Fax:
Practice Address - Street 1:73 1ST AVE
Practice Address - Street 2:APT.B
Practice Address - City:ATLANTIC HIGHLANDS
Practice Address - State:NJ
Practice Address - Zip Code:07716-1241
Practice Address - Country:US
Practice Address - Phone:732-291-4235
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR07791200282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital