Provider Demographics
NPI:1629041603
Name:COUNTY OF BURLINGTON
Entity Type:Organization
Organization Name:COUNTY OF BURLINGTON
Other - Org Name:BUTTONWOOD HOSPITAL OF BURLINGTON COUNTY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:EVE
Authorized Official - Middle Name:A
Authorized Official - Last Name:CULLINAN
Authorized Official - Suffix:
Authorized Official - Credentials:LNHA
Authorized Official - Phone:609-726-7000
Mailing Address - Street 1:PO BOX 6000
Mailing Address - Street 2:
Mailing Address - City:MOUNT HOLLY
Mailing Address - State:NJ
Mailing Address - Zip Code:08060-6000
Mailing Address - Country:US
Mailing Address - Phone:609-726-7000
Mailing Address - Fax:609-726-1753
Practice Address - Street 1:600 PEMBERTON-BROWNS MILLS ROAD
Practice Address - Street 2:
Practice Address - City:NEW LISBON
Practice Address - State:NJ
Practice Address - Zip Code:08064
Practice Address - Country:US
Practice Address - Phone:609-726-7000
Practice Address - Fax:609-726-1753
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-09
Last Update Date:2007-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ060302314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ4466501OtherUNISYS
NJ03510Medicaid
NJ4466501OtherUNISYS