NPIMap

Organization Active NPI

Penn Family Medicine at Cherry Hill

  • Non-Pharmacy Dispensing Site
  • Cherry Hill, NJ
National Provider Identifier
1932241585
Registry record updated Aug 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
License
25MA05022600 Issued in NJ
Legal business name
PENN FAMILY MEDICINE AT CHERRY HILL
Practice address
409 Marlton Pike E
Cherry Hill, NJ 08034-2413
Phone
(856) 427-4336
NPI assigned
Feb 12, 2007
Organization subpart
Yes
Parent organization
MEDVANTX, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 23, 2010

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

Authorized official

Name
Kenny Heine
Title
Director of Operations
Phone
(858) 625-2990

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X 25MA05022600 NJ Primary

Addresses

Primary practice location

409 Marlton Pike E
Cherry Hill, NJ 08034-2413

Mailing address

5810 Nancy Ridge Dr
San Diego, CA 92121-2834
Phone (858) 625-2990

National Provider Directory

National Provider Directory
Tax ID family
Clinical Health Care Associates of New Jersey PC16 organizations share this tax ID, including this one
Part of
Tri - State Medical Group Inc

Other organizations with this tax ID 15

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

View all 15

Locations

5810 Nancy Ridge Dr
San Diego, CA 92121

NPI Registry JSON

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1282521600000",
    "number": "1932241585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5810 NANCY RIDGE DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921212834",
            "telephone_number": "858-625-2990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 MARLTON PIKE E",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080342413",
            "telephone_number": "856-427-4336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENN FAMILY MEDICINE AT CHERRY HILL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEDVANTX, INC.",
        "enumeration_date": "2007-02-12",
        "last_updated": "2010-08-23",
        "status": "A",
        "authorized_official_last_name": "HEINE",
        "authorized_official_first_name": "KENNY",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "858-625-2990"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "NJ",
            "license": "25MA05022600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cherry Hill, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 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.