NPIMap

Organization Active NPI

South Jersey Healthcare Life, Inc.

  • PACE Provider Organization
  • Vineland, NJ
National Provider Identifier
1033415740
Registry record updated Jan 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PACE Provider OrganizationTaxonomy code 251T00000X
Legal business name
SOUTH JERSEY HEALTHCARE LIFE, INC.
Practice address
2950 College Dr
Suite 1E
Vineland, NJ 08360-6933
Phone
(856) 641-8624
Fax
(856) 641-8641
NPI assigned
Jan 28, 2011
Organization subpart
Yes
Parent organization
SOUTH JERSEY HEALTH SYSTEM, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 28, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Wayne Pendleton, MSW
Title
Executive Director, Pace
Phone
(856) 878-6005

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PACE Provider Organization 251T00000X Primary

Addresses

Primary practice location

2950 College Dr
Suite 1E
Vineland, NJ 08360-6933

Mailing address

2445 S Delsea Dr
Vineland, NJ 08360-7000
Phone (856) 878-6005

National Provider Directory

National Provider Directory
Tax ID family
Inspira Health Network4 organizations share this tax ID, including this one
Part of
Inspira Health Network

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1296172800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1296172800000",
    "number": "1033415740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2445 S DELSEA DR",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "083607000",
            "telephone_number": "856-878-6005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2950 COLLEGE DR",
            "address_2": "SUITE 1E",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "083606933",
            "telephone_number": "856-641-8624",
            "fax_number": "856-641-8641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH JERSEY HEALTHCARE LIFE, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUTH JERSEY HEALTH SYSTEM, INC.",
        "enumeration_date": "2011-01-28",
        "last_updated": "2011-01-28",
        "status": "A",
        "authorized_official_last_name": "PENDLETON",
        "authorized_official_first_name": "WAYNE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR, PACE",
        "authorized_official_telephone_number": "856-878-6005",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MSW"
    },
    "taxonomies": [
        {
            "code": "251T00000X",
            "taxonomy_group": "",
            "desc": "Program of All-Inclusive Care for the Elderly (PACE) Provider Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vineland, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.