NPIMap

Organization Active NPI

Our Lady of Lourdes Medical Center

Doing business as OLOLMC Surgical Associates

  • Surgery Physician
  • Sicklerville, NJ
National Provider Identifier
1326212671
Registry record updated Mar 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
25MA05349300 Issued in NJ
Legal business name
OUR LADY OF LOURDES MEDICAL CENTER
Doing business as
OLOLMC Surgical Associates
Practice address
416 Sicklerville Rd
Sicklerville, NJ 08081-2556
Phone
(856) 629-1273
NPI assigned
Apr 17, 2008
Reactivated
Mar 30, 2010
Last updated
Mar 30, 2010By the provider in NPPES
Organization subpart
Yes
Parent organization
OUR LADY OF LOURDES MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 30, 2010

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

Authorized official

Name
Andrew Guarni
Title
Cfo
Phone
(856) 824-3027

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X 25MA05349300 NJ Primary

Addresses

Primary practice location

416 Sicklerville Rd
Sicklerville, NJ 08081-2556

Mailing address

500 Grove St
Suite 100
Haddon Heights, NJ 08035-1702
Phone (856) 796-9200

Other names 1

  • OLOLMC Surgical Associates Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Virtua Our Lady of Lourdes Hospital Inc7 organizations share this tax ID, including this one
Part of
Virtua Our Lady of Lourdes Hospital Inc

Other organizations with this tax ID 6

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": "1208390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1269907200000",
    "number": "1326212671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 GROVE ST",
            "address_2": "SUITE 100",
            "city": "HADDON HEIGHTS",
            "state": "NJ",
            "postal_code": "080351702",
            "telephone_number": "856-796-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "416 SICKLERVILLE RD",
            "city": "SICKLERVILLE",
            "state": "NJ",
            "postal_code": "080812556",
            "telephone_number": "856-629-1273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OUR LADY OF LOURDES MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "OUR LADY OF LOURDES MEDICAL CENTER",
        "enumeration_date": "2008-04-17",
        "last_updated": "2010-03-30",
        "deactivation_date": "2010-01-21",
        "reactivation_date": "2010-03-30",
        "status": "A",
        "authorized_official_last_name": "GUARNI",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "856-824-3027"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "NJ",
            "license": "25MA05349300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OLOLMC Surgical Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sicklerville, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2010; 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.