Provider Demographics
NPI:1376858365
Name:VINELAND HEALTH DEPARTMENT PUBLIC HEALTH NURSING
Entity Type:Organization
Organization Name:VINELAND HEALTH DEPARTMENT PUBLIC HEALTH NURSING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PUBLIC HEALTH NURSE SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:CUBBAGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-794-4000
Mailing Address - Street 1:PO BOX 1508
Mailing Address - Street 2:
Mailing Address - City:VINELAND
Mailing Address - State:NJ
Mailing Address - Zip Code:08362-1508
Mailing Address - Country:US
Mailing Address - Phone:856-794-4000
Mailing Address - Fax:856-362-8986
Practice Address - Street 1:610 E MONTROSE ST
Practice Address - Street 2:SUITE 1
Practice Address - City:VINELAND
Practice Address - State:NJ
Practice Address - Zip Code:08360-4660
Practice Address - Country:US
Practice Address - Phone:856-794-4000
Practice Address - Fax:856-362-8986
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-13
Last Update Date:2010-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare