Provider Demographics
NPI:1689430514
Name:VIRTUA OUR LADY OF LOURDES HOSPITAL INC
Entity Type:Organization
Organization Name:VIRTUA OUR LADY OF LOURDES HOSPITAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF REIMBURSEMENT
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:C
Authorized Official - Last Name:GORDON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-355-0655
Mailing Address - Street 1:728 MARNE HIGHWAY
Mailing Address - Street 2:SUITE 100D ATTN: STEVE REGN
Mailing Address - City:MOORESTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08057
Mailing Address - Country:US
Mailing Address - Phone:856-206-4790
Mailing Address - Fax:
Practice Address - Street 1:728 MARNE HIGHWAY
Practice Address - Street 2:SUITE 100D ATTN: STEVE REGN
Practice Address - City:MOORESTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08057
Practice Address - Country:US
Practice Address - Phone:856-206-4790
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VIRTUA HEALTH INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-02-27
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246X00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist CardiovascularGroup - Multi-Specialty