NPIMap

Organization Active NPI

Pinnacle Treatment Centers NJ III LLC

Doing business as Pennsville Treatment Services

  • Methadone Clinic
  • Pennsville, NJ
National Provider Identifier
1851902787
Registry record updated Apr 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Methadone ClinicTaxonomy code 261QM2800X
Legal business name
PINNACLE TREATMENT CENTERS NJ III LLC
Doing business as
Pennsville Treatment Services
Practice address
250 S Broadway Ste C&D
Pennsville, NJ 08070-2700
Phone
(856) 759-6073
NPI assigned
Aug 13, 2020
Last updated
Apr 13, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2021

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

Authorized official

Name
Robyn Tanis
Title
Executive Director of Contract MGMT
Phone
(856) 533-8762

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Methadone Clinic 261QM2800X NU Primary
Recovery Care Clinic/Center 261QR0800X NU

Addresses

Primary practice location

250 S Broadway Ste C&D
Pennsville, NJ 08070-2700

Mailing address

1317 Route 73 Ste 200
Mount Laurel, NJ 08054-2202
Phone (856) 396-1114

Other practice location 1

250 S Broadway
Pennsville, NJ 08070-2700
Phone (856) 759-6073

Other names 1

  • Pennsville Treatment Services Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200131001378 NJ Part B Supplier - Opioid Treatment Program (Otp) 4284060799 5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Hamilton, NJ; Pennsauken, NJ; Somerdale, NJ; Trenton, NJ; Vineland, NJ

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1597276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618272000000",
    "number": "1851902787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1317 ROUTE 73 STE 200",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080542202",
            "telephone_number": "856-396-1114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 S BROADWAY STE C&D",
            "city": "PENNSVILLE",
            "state": "NJ",
            "postal_code": "080702700",
            "telephone_number": "856-759-6073"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "250 S Broadway",
            "address_purpose": "LOCATION",
            "city": "Pennsville",
            "state": "NJ",
            "postal_code": "080702700",
            "country_code": "US",
            "telephone_number": "856-759-6073",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PINNACLE TREATMENT CENTERS NJ III LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-13",
        "last_updated": "2021-04-13",
        "certification_date": "2021-04-13",
        "status": "A",
        "authorized_official_last_name": "TANIS",
        "authorized_official_first_name": "ROBYN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR OF CONTRACT MGMT",
        "authorized_official_telephone_number": "856-533-8762"
    },
    "taxonomies": [
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Recovery Care",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pennsville Treatment Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Pennsville Treatment Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pennsville, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.