Provider Demographics
NPI:1578559340
Name:CAMDEN COUNTY HEALTH SERVICES CENTER
Entity Type:Organization
Organization Name:CAMDEN COUNTY HEALTH SERVICES CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:GENE
Authorized Official - Middle Name:
Authorized Official - Last Name:LYNAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-374-6500
Mailing Address - Street 1:425 WOODBURY TURNERSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:BLACKWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08012-2960
Mailing Address - Country:US
Mailing Address - Phone:856-374-6479
Mailing Address - Fax:856-374-6469
Practice Address - Street 1:425 WOODBURY TURNERSVILLE RD
Practice Address - Street 2:
Practice Address - City:BLACKWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08012-2960
Practice Address - Country:US
Practice Address - Phone:856-374-6479
Practice Address - Fax:856-374-6469
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-27
Last Update Date:2009-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22265283Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ4508700Medicaid
NJ2505100Medicaid
NJ4508700Medicaid
NJ012051Medicare ID - Type UnspecifiedCMS MEDICAL PHYSICIAN
NJ2505100Medicaid