Provider Demographics
NPI:1972556942
Name:CHERRY HILL WOMEN'S CENTER, INC.
Entity Type:Organization
Organization Name:CHERRY HILL WOMEN'S CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING COORDINATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:GRIFFIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-356-4025
Mailing Address - Street 1:601 CHAPEL AVE E
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08034-1407
Mailing Address - Country:US
Mailing Address - Phone:856-356-4025
Mailing Address - Fax:856-356-4038
Practice Address - Street 1:502 KINGS HWY N
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08034-1502
Practice Address - Country:US
Practice Address - Phone:856-667-5910
Practice Address - Fax:856-356-4038
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-18
Last Update Date:2014-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22445 A261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6353908Medicaid
NJ6353908Medicaid