Basic Information
Provider Information
NPI: 1962048231
EntityType: 2
ReplacementNPI:  
OrganizationName: INSPIRA MEDICAL CENTERS, INC.
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
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Mailing Information
Address1: 333 IRVING AVE
Address2:  
City: BRIDGETON
State: NJ
PostalCode: 083022123
CountryCode: US
TelephoneNumber: 8565754777
FaxNumber: 8565754951
Practice Location
Address1: 1505 W SHERMAN AVE
Address2:  
City: VINELAND
State: NJ
PostalCode: 083607059
CountryCode: US
TelephoneNumber: 8566418000
FaxNumber: 8566417632
Other Information
ProviderEnumerationDate: 11/21/2019
LastUpdateDate: 11/21/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: O'CONNELL
AuthorizedOfficialFirstName: JAMES
AuthorizedOfficialMiddleName: THOMAS
AuthorizedOfficialTitleorPosition: DIRECTOR REVENUE CYCLE
AuthorizedOfficialTelephone: 8565754777
IsSoleProprietor:  
IsOrganizationSubpart: Y
ParentOrganizationLBN: INSPIRA MEDICAL CENTERS, INC.
AuthorizedOfficialNamePrefix:  
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AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
3336C0003X  Y SuppliersPharmacyCommunity/Retail Pharmacy

No ID Information.


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