Provider Demographics
NPI:1922351576
Name:SKILLED CARE OF SOUTH JERSEY LLC
Entity Type:Organization
Organization Name:SKILLED CARE OF SOUTH JERSEY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:GEROGINA
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMPIONE
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN
Authorized Official - Phone:856-220-8522
Mailing Address - Street 1:417 DORCHESTER DR
Mailing Address - Street 2:
Mailing Address - City:DELRAN
Mailing Address - State:NJ
Mailing Address - Zip Code:08075-1369
Mailing Address - Country:US
Mailing Address - Phone:856-220-8522
Mailing Address - Fax:
Practice Address - Street 1:417 DORCHESTER DR
Practice Address - Street 2:
Practice Address - City:DELRAN
Practice Address - State:NJ
Practice Address - Zip Code:08075-1369
Practice Address - Country:US
Practice Address - Phone:856-220-8522
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-19
Last Update Date:2012-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health