Provider Demographics
NPI:1679148712
Name:ATLANTICARE HEALTH SERVICES INC.
Entity Type:Organization
Organization Name:ATLANTICARE HEALTH SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:CARL
Authorized Official - Last Name:APGAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-572-6006
Mailing Address - Street 1:1401 ATLANTIC AVE STE 2600
Mailing Address - Street 2:
Mailing Address - City:ATLANTIC CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:08401-7001
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:227 N VERMONT AVE FL 1
Practice Address - Street 2:
Practice Address - City:ATLANTIC CITY
Practice Address - State:NJ
Practice Address - Zip Code:08401-5563
Practice Address - Country:US
Practice Address - Phone:609-572-8800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ATLANTICARE HEALTH SERVICES INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-05-21
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center