Broadway Community Health Care, Inc

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

26NN10322000 Issued in NJ

Legal business name

BROADWAY COMMUNITY HEALTH CARE, INC

Practice address

442 S Broadway
Camden, NJ 08103-1246

Phone

(856) 365-1707

Fax

(856) 365-1737

NPI assigned

Feb 22, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Patrick Aime Ervilus, PHD, FNP-C, PMHNP-C

Title

Provider

Phone

(856) 365-1707

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1361491200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1372032000000",
    "number": "1386984763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "442 S BROADWAY",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031246",
            "telephone_number": "856-365-1707",
            "fax_number": "856-365-1737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "442 S BROADWAY",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031246",
            "telephone_number": "856-365-1707",
            "fax_number": "856-365-1737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROADWAY COMMUNITY HEALTH CARE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-22",
        "last_updated": "2013-06-24",
        "status": "A",
        "authorized_official_last_name": "ERVILUS",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_middle_name": "AIME",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "856-365-1707",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD, FNP-C, PMHNP-C"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NJ",
            "license": "26NN10322000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eleni Nicole Brecht, PA-C
• Mark D Brennan, M.D.
• Jeffrey Craig Brenner, M.D.
• Sheppard Robert Brewster, NP
• Kristin L Brill, MD
• Broadway Discount Pharmacy Inc
• Broadway Foot & Ankle Center
• Marion B. Brody, MD
• Carly Ana Brogan
• Holly L. Brogan, CRNA

• Primary Care Clinic/Center in Camden, NJ
• Providers in Camden, NJ by specialty
• Primary Care Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2013; 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.