Provider Demographics
NPI:1942729637
Name:HEALTHCARE COMMONS, INC.
Entity Type:Organization
Organization Name:HEALTHCARE COMMONS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:R
Authorized Official - Last Name:GROSS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-299-3200
Mailing Address - Street 1:500 S PENNSVILLE AUBURN RD
Mailing Address - Street 2:
Mailing Address - City:CARNEYS POINT
Mailing Address - State:NJ
Mailing Address - Zip Code:08069-2936
Mailing Address - Country:US
Mailing Address - Phone:856-299-3200
Mailing Address - Fax:856-299-6070
Practice Address - Street 1:6 HOWARD ST
Practice Address - Street 2:
Practice Address - City:PENNS GROVE
Practice Address - State:NJ
Practice Address - Zip Code:08069-1524
Practice Address - Country:US
Practice Address - Phone:856-299-3200
Practice Address - Fax:856-299-6070
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-13
Last Update Date:2017-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ4544803Medicaid