Delaware Valley Medical, Inc.

Primary specialty

Methadone ClinicTaxonomy code 261QM2800X

License

20000238-07 Issued in NJ

Legal business name

DELAWARE VALLEY MEDICAL, INC.

Practice address

300 Woodbury Turnersville Rd
Blackwood, NJ 08012-2860

Phone

(856) 227-5254

Fax

(856) 665-5212

NPI assigned

Apr 7, 2007

Organization subpart

No

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

Authorized official

Name

Linda Voorhis, BA, CADC, CCS

Title

Chief Executive Director

Phone

(856) 665-5100

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Delaware Valley Medical, Inc. Blackwood Clinic Other name

Tax ID family

Delaware Valley Medical Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Delaware Valley Medical, Inc.

  • Methadone Clinic
  • Pennsauken, NJ
  • NPI 1174646095
  NPD tax ID

Locations

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

{
    "created_epoch": "1175904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1700909629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8697",
            "city": "COLLINGSWOOD",
            "state": "NJ",
            "postal_code": "081088697",
            "telephone_number": "856-665-5100",
            "fax_number": "856-665-5212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 WOODBURY TURNERSVILLE RD",
            "city": "BLACKWOOD",
            "state": "NJ",
            "postal_code": "080122860",
            "telephone_number": "856-227-5254",
            "fax_number": "856-665-5212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DELAWARE VALLEY MEDICAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "VOORHIS",
        "authorized_official_first_name": "LINDA",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "856-665-5100",
        "authorized_official_credential": "BA, CADC, CCS"
    },
    "taxonomies": [
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": "NJ",
            "license": "20000238-07",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "APPLIED FOR",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Delaware Valley Medical, Inc. Blackwood Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Methadone Clinic in Blackwood, NJ
• Providers in Blackwood, NJ by specialty
• Methadone Clinic in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.