NPIMap

Organization Active NPI

Lourdes Medical Associates PA

Doing business as LMA Willingboro Town Center

  • Non-Pharmacy Dispensing Site
  • Willingboro, NJ
National Provider Identifier
1063850626
Registry record updated Jun 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
License
25MA04258100 Issued in NJ
Legal business name
LOURDES MEDICAL ASSOCIATES PA
Doing business as
LMA Willingboro Town Center
Practice address
200 Campbell Dr
Suite 102
Willingboro, NJ 08046-1067
Phone
(609) 877-4545
NPI assigned
Jun 5, 2013
Last updated
Jun 5, 2015By the provider in NPPES
Organization subpart
Yes
Parent organization
MEDVANTX, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 5, 2015

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

Authorized official

Name
Kenny Heine
Title
VP of Operations
Phone
(858) 964-1506

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X 25MA04258100 NJ Primary

Addresses

Primary practice location

200 Campbell Dr
Suite 102
Willingboro, NJ 08046-1067

Mailing address

5626 Oberlin Dr
Suite 110
San Diego, CA 92121-1705

Other names 1

  • LMA Willingboro Town Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Laurdes Medical Associa65 organizations share this tax ID, including this one
Part of
Medvantx Inc

Organizations with this tax ID in the same state 14

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 14

Locations

200 Campbell Dr
Ste 102
Willingboro, NJ 08046
Phone (609) 877-4545

NPI Registry JSON

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

{
    "created_epoch": "1370390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433462400000",
    "number": "1063850626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5626 OBERLIN DR",
            "address_2": "SUITE 110",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921211705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 CAMPBELL DR",
            "address_2": "SUITE 102",
            "city": "WILLINGBORO",
            "state": "NJ",
            "postal_code": "080461067",
            "telephone_number": "609-877-4545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOURDES MEDICAL ASSOCIATES PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEDVANTX, INC",
        "enumeration_date": "2013-06-05",
        "last_updated": "2015-06-05",
        "status": "A",
        "authorized_official_last_name": "HEINE",
        "authorized_official_first_name": "KENNY",
        "authorized_official_title_or_position": "VP OF OPERATIONS",
        "authorized_official_telephone_number": "858-964-1506"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "NJ",
            "license": "25MA04258100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LMA Willingboro Town Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Willingboro, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2015; 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.