Provider Demographics
NPI:1699828111
Name:ENAM CORPORATION
Entity Type:Organization
Organization Name:ENAM CORPORATION
Other - Org Name:ANNA'S ANGELS PEDIATRIC MEDICAL DAYCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF NURSING
Authorized Official - Prefix:MS
Authorized Official - First Name:MARILYN
Authorized Official - Middle Name:
Authorized Official - Last Name:MCGUINNESS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:856-456-3450
Mailing Address - Street 1:PO BOX 266
Mailing Address - Street 2:
Mailing Address - City:GLOUCESTER CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:08030-0266
Mailing Address - Country:US
Mailing Address - Phone:856-456-3450
Mailing Address - Fax:856-456-3451
Practice Address - Street 1:238 MERCER ST
Practice Address - Street 2:
Practice Address - City:GLOUCESTER CITY
Practice Address - State:NJ
Practice Address - Zip Code:08030-1429
Practice Address - Country:US
Practice Address - Phone:856-456-3450
Practice Address - Fax:856-456-3451
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ158226261QM3000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM3000XAmbulatory Health Care FacilitiesClinic/CenterMedically Fragile Infants and Children Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0040690Medicaid