Provider Demographics
NPI:1962484659
Name:COUNTY OF CAPE MAY
Entity Type:Organization
Organization Name:COUNTY OF CAPE MAY
Other - Org Name:CAPE MAY COUNTY HEALTH DEPARTMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PUBLIC HEALTH COORDINATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:MA, PHC
Authorized Official - Phone:609-465-1187
Mailing Address - Street 1:6 MOORE RD # DN601
Mailing Address - Street 2:
Mailing Address - City:CAPE MAY COURT HOUSE
Mailing Address - State:NJ
Mailing Address - Zip Code:08210-1654
Mailing Address - Country:US
Mailing Address - Phone:609-465-1187
Mailing Address - Fax:609-465-3933
Practice Address - Street 1:1261 ROUTE 9 S STE 5A
Practice Address - Street 2:
Practice Address - City:CAPE MAY COURT HOUSE
Practice Address - State:NJ
Practice Address - Zip Code:08210-2761
Practice Address - Country:US
Practice Address - Phone:609-465-1187
Practice Address - Fax:609-465-3933
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COUNTY OF CAPE MAY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-11-17
Last Update Date:2019-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22384251E00000X
NJ70501261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3688020Medicaid
NJ3688020Medicaid
NJ316504Medicare ID - Type UnspecifiedPHYSICAL THERAPY CLINIC