Provider Demographics
NPI:1922094796
Name:CAMDEN COUNTY HEALTH SERVICES CENTER
Entity Type:Organization
Organization Name:CAMDEN COUNTY HEALTH SERVICES CENTER
Other - Org Name:CAMDEN CNTY HEALTH SVCS CNTR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FISCAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:
Authorized Official - Last Name:KINNEY
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:856-374-6600
Mailing Address - Street 1:425 WOODBURY TURNERSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:BLACKWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08012-2960
Mailing Address - Country:US
Mailing Address - Phone:856-374-6461
Mailing Address - Fax:856-374-6994
Practice Address - Street 1:425 WOODBURY TURNERSVILLE RD
Practice Address - Street 2:
Practice Address - City:BLACKWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08012-2960
Practice Address - Country:US
Practice Address - Phone:856-374-6461
Practice Address - Fax:856-374-6994
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-27
Last Update Date:2014-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336L0003X
NJ28RS001842003336I0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336I0012XSuppliersPharmacyInstitutional Pharmacy
No333600000XSuppliersPharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ4429214Medicaid
NJ4429206Medicaid
2055652OtherPK