Provider Demographics
NPI: | 1639657588 |
---|---|
Name: | CHERRY HILL WOMEN'S CENTER, INC. |
Entity Type: | Organization |
Organization Name: | CHERRY HILL WOMEN'S CENTER, INC. |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | COO |
Authorized Official - Prefix: | |
Authorized Official - First Name: | ANGELA |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | LAZARUS |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 568-356-4001 |
Mailing Address - Street 1: | 601 CHAPEL AVE E |
Mailing Address - Street 2: | |
Mailing Address - City: | CHERRY HILL |
Mailing Address - State: | NJ |
Mailing Address - Zip Code: | 08034-1454 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 856-356-4001 |
Mailing Address - Fax: | 856-414-1660 |
Practice Address - Street 1: | 502 KINGS HWY N |
Practice Address - Street 2: | |
Practice Address - City: | CHERRY HILL |
Practice Address - State: | NJ |
Practice Address - Zip Code: | 08034-1502 |
Practice Address - Country: | US |
Practice Address - Phone: | 856-667-5910 |
Practice Address - Fax: | 856-667-8304 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2018-08-02 |
Last Update Date: | 2018-08-02 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
NJ | 22445 | 261QA1903X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 261QA1903X | Ambulatory Health Care Facilities | Clinic/Center | Ambulatory Surgical |