Provider Demographics
NPI:1578004289
Name:PRIME HEALTHCARE FOUNDATION - SALEM HOSPITAL LLC
Entity Type:Organization
Organization Name:PRIME HEALTHCARE FOUNDATION - SALEM HOSPITAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF COMPLIANCE COUNSEL
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:DOAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-235-4307
Mailing Address - Street 1:310 SALEM WOODSTOWN RD
Mailing Address - Street 2:2ND FLOOR, 2 EAST
Mailing Address - City:SALEM
Mailing Address - State:NJ
Mailing Address - Zip Code:08079-2064
Mailing Address - Country:US
Mailing Address - Phone:856-678-8500
Mailing Address - Fax:856-678-5180
Practice Address - Street 1:310 SALEM WOODSTOWN RD
Practice Address - Street 2:2ND FLOOR, 2 EAST
Practice Address - City:SALEM
Practice Address - State:NJ
Practice Address - Zip Code:08079-2064
Practice Address - Country:US
Practice Address - Phone:856-678-8500
Practice Address - Fax:856-678-5180
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-14
Last Update Date:2017-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based