Atlanticare Physician Group PA

Organization Active NPI Non-Pharmacy Dispensing Site · Little Egg Harbor TWP, NJ

NPI 1255787404 · NPPES record last updated May 6, 2016

Key facts

NPI
1255787404
Entity type
Organization (NPI type 2)
Primary specialty
Non-Pharmacy Dispensing Site 332900000X
License
25MA05773200 (NJ)
Legal business name
ATLANTICARE PHYSICIAN GROUP PA
Practice address
459 Route 9 S
Little Egg Harbor TWP, NJ 08087-2225
Phone
(609) 407-2273
NPI assigned
May 6, 2016
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

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

National Provider Directory

Tax ID family
Atlanitcare Physician Group (22 organizations share this tax ID)
Part of
Tri - State Medical Group Inc

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X 25MA05773200 NJ Yes

Addresses

Primary practice location

459 Route 9 S
Little Egg Harbor TWP, NJ 08087-2225

Mailing address

9276 Scranton Rd
Suite 100
San Diego, CA 92121-7701

Other names

  • AtlantiCare Urgent Care - Little Egg Harbor Doing business as

Other providers in Little Egg Harbor TWP, NJ

All providers in Little Egg Harbor TWP, NJ · Non-Pharmacy Dispensing Site in New Jersey

Sources for this page

Verify at the official NPI Registry.