Provider Demographics
NPI:1831143890
Name:INSPIRA MEDICAL CENTERS, INC.
Entity Type:Organization
Organization Name:INSPIRA MEDICAL CENTERS, INC.
Other - Org Name:INSPIRA INPATIENT ADULT BEHAVIORAL HEALTH BRIDGETON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF REVENUE CYCLE
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:O'CONNELL
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:856-575-4777
Mailing Address - Street 1:333 IRVING AVENUE
Mailing Address - Street 2:
Mailing Address - City:BRIDGETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08302-2100
Mailing Address - Country:US
Mailing Address - Phone:856-575-4500
Mailing Address - Fax:856-451-5269
Practice Address - Street 1:333 IRVING AVENUE
Practice Address - Street 2:
Practice Address - City:BRIDGETON
Practice Address - State:NJ
Practice Address - Zip Code:08302-2100
Practice Address - Country:US
Practice Address - Phone:856-575-4500
Practice Address - Fax:856-451-5269
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:INSPIRA MEDICAL CENTERS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-22
Last Update Date:2013-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ10603273R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3674509Medicaid
NJ3674509Medicaid