Our Lady of Lourdes Medical Center

Primary specialty

End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X

License

10404 Issued in NJ

Legal business name

OUR LADY OF LOURDES MEDICAL CENTER

Doing business as

Lourdes Mt. Laurel Dialysis Unit

Practice address

130 Gaither Dr
Suite 172
Mount Laurel, NJ 08054-1715

Phone

(856) 757-3776

NPI assigned

Aug 24, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Andrew Guarni

Title

Cfo

Phone

(856) 824-3131

Specialties & licenses 1

Addresses

Other names 1

• Lourdes Mt. Laurel Dialysis Unit Doing business as

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Virtua Our Lady of Lourdes Hospital Inc

  • General Acute Care Hospital
  • Camden, NJ
  • NPI 1235134024

  Member Of

  NPD member

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

{
    "created_epoch": "1124841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196985600000",
    "number": "1174516280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 FRONT ST",
            "city": "RIVERSIDE",
            "state": "NJ",
            "postal_code": "080751181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 GAITHER DR",
            "address_2": "SUITE 172",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080541715",
            "telephone_number": "856-757-3776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OUR LADY OF LOURDES MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-24",
        "last_updated": "2007-12-07",
        "status": "A",
        "authorized_official_last_name": "GUARNI",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "856-824-3131",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "NJ",
            "license": "10404",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lourdes Mt. Laurel Dialysis Unit",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Optibmize LLC
• Optimum Choice Laboratory
• Mari R Oresic, MSS, LCSW
• Melanie Orwig, LSW
• Juliette Osborne, NURSE PRACTITIONER
• Andrea J Pagan, RBT
• Deloras Lillie Pagan
• Pain Relief Center of South Jersey LLC
• Molly Pak, PA-C
• Nicole Erin Palmer, MS, CCC-SLP

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Mount Laurel, NJ
• Providers in Mount Laurel, NJ by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2007; 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.