Provider Demographics
NPI:1972610525
Name:CAPITAL HEALTH SYSTEM
Entity Type:Organization
Organization Name:CAPITAL HEALTH SYSTEM
Other - Org Name:CAPITAL HEALTH - HOPEWELL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIR OF PHCY
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:
Authorized Official - Last Name:BEVENOUR
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:609-394-6079
Mailing Address - Street 1:1 CAPITAL WAY
Mailing Address - Street 2:
Mailing Address - City:PENNINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08534-2520
Mailing Address - Country:US
Mailing Address - Phone:609-815-7657
Mailing Address - Fax:609-815-7599
Practice Address - Street 1:1 CAPITAL WAY
Practice Address - Street 2:
Practice Address - City:PENNINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08534-2520
Practice Address - Country:US
Practice Address - Phone:609-815-7657
Practice Address - Fax:609-815-7071
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-23
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ31DO121851282N00000X
333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ4138201Medicaid
NJ4138201Medicaid