Provider Demographics
NPI:1508035064
Name:CAMCARE HEALTH CORPORATION
Entity Type:Organization
Organization Name:CAMCARE HEALTH CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PATIENT ACCOUNTS
Authorized Official - Prefix:MS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:L
Authorized Official - Last Name:WURST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-583-2412
Mailing Address - Street 1:817 FEDERAL ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:CAMDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08103-1539
Mailing Address - Country:US
Mailing Address - Phone:856-541-5933
Mailing Address - Fax:856-541-3340
Practice Address - Street 1:121 WHITE HORSE PIKE
Practice Address - Street 2:
Practice Address - City:CLEMENTON
Practice Address - State:NJ
Practice Address - Zip Code:08021-4158
Practice Address - Country:US
Practice Address - Phone:856-541-5933
Practice Address - Fax:856-541-3340
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-28
Last Update Date:2014-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ70471261QF0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0133752Medicaid
NJ0133752Medicaid