Provider Demographics
NPI:1366471278
Name:COUNTY OF ATLANTIC
Entity Type:Organization
Organization Name:COUNTY OF ATLANTIC
Other - Org Name:ATLANTIC COUNTY DIVISION OF PUBLIC HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:HEALTH OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:DIAMOND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-645-5935
Mailing Address - Street 1:201 S. SHORE ROAD
Mailing Address - Street 2:COMMUNITY HEALTH
Mailing Address - City:NORTHFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:08225
Mailing Address - Country:US
Mailing Address - Phone:609-645-5933
Mailing Address - Fax:609-272-8490
Practice Address - Street 1:201 SHORE RD
Practice Address - Street 2:COMMUNITY HEALTH
Practice Address - City:NORTHFIELD
Practice Address - State:NJ
Practice Address - Zip Code:08225-2319
Practice Address - Country:US
Practice Address - Phone:609-645-5933
Practice Address - Fax:609-272-8490
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-02
Last Update Date:2008-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0118478Medicaid
NJ2073137OtherAETNA
NJ2073137OtherAETNA