Provider Demographics
NPI:1306817978
Name:SALEM HOSPITAL CORPORATION
Entity Type:Organization
Organization Name:SALEM HOSPITAL CORPORATION
Other - Org Name:MEMORIAL HOSPITAL OF SALEM COUNTY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR/DELEGATED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:
Authorized Official - Last Name:LALOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-925-4565
Mailing Address - Street 1:PO BOX 503899
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63150-3899
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:310 WOODSTOWN RD
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:NJ
Practice Address - Zip Code:08079-2064
Practice Address - Country:US
Practice Address - Phone:856-935-1000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-31
Last Update Date:2018-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ71702282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ9031308Medicaid
H05665OtherOXFORD
IL5384OtherHEALTHNET IP
23203OtherAMERIGROUP
SA000000802OtherAMERICHOICE
DE1000025870Medicaid
11254OtherDEVON
310091OtherBCBS
SI000000802OtherAMERICHOICE
II5385OtherHEALTHNET OP
1016100OtherHORIZON MERCY
13062OtherAENTA
0001207000OtherKEYSTONE
II5385OtherHEALTHNET OP
NJ310091Medicare Oscar/Certification