Atlanticare Physician Group PA
Organization Active NPI Non-Pharmacy Dispensing Site · Galloway, NJ
NPI 1083000707 · NPPES record last updated Apr 29, 2015
Key facts
- NPI
- 1083000707
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Non-Pharmacy Dispensing Site 332900000X
- License
- 25MB05380400 (NJ)
- Legal business name
- ATLANTICARE PHYSICIAN GROUP PA
- Practice address
- 110 E Jimmie Leeds Rd
Galloway, NJ 08205-9508 - Phone
- (609) 748-2100
- NPI assigned
- Apr 9, 2015
- Organization subpart
- Yes
- Parent organization (as reported)
- MEDVANTX, INC.
Authorized official
- Name
- Kenny Heine
- Title
- VP of Operations
- Phone
- (858) 964-1506
Corporate family (same tax ID) 21
National Provider Directory
- Tax ID family
- Atlanitcare Physician Group
- Part of
- Tri - State Medical Group Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Non-Pharmacy Dispensing Site | 332900000X | 25MB05380400 | NJ | Yes |
Addresses
Primary practice location
110 E Jimmie Leeds Rd
Galloway, NJ 08205-9508
Mailing address
5626 Oberlin Dr
Suite 110
San Diego, CA 92121-1705
Other names
- AtlantiCare Urgent Care- Galloway Township
Other providers in Galloway, NJ
- Atlantic Pulmonary & Critical Care Associates PA
- Atlantic Regional Cancer Center, LLC
- Atlantic Sleep Health Diagnostic Associates LLC
- Atlanticare Behavioral Health, Inc
- Atlanticare Health Services Inc.
- Atlanticare Physician Group, PA
- Atlanticare Regional Medical Center
- Atsi Wellness Group
- John Minkah Attobrah
- Eve Atwell
All providers in Galloway, NJ · Non-Pharmacy Dispensing Site in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 29, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.