Compassionate Care Oral Surgery LLC
Organization Active NPI Clinic/Center · Williamstown, NJ
NPI 1962857573 · NPPES record last updated May 2, 2016
Key facts
- NPI
- 1962857573
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinic/Center 261Q00000X
- License
- 22DIO2212104 (NJ)
- Legal business name
- COMPASSIONATE CARE ORAL SURGERY LLC
- Practice address
- 1035 N Black Horse Pike
Suite #7
Williamstown, NJ 08094-2840 - Phone
- (856) 740-1300
- Fax
- (856) 740-1302
- NPI assigned
- May 2, 2016
- Organization subpart
- No
Authorized official
- Name
- Dr. Rebekah Brevard, DMD
- Title
- Oral Surgeon
- Phone
- (609) 385-7843
Practitioners 1
-
Rebekah R Brevard, DMD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NJ
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20160708001401 | NJ | Part B Supplier - Clinic/Group Practice | 0244522472 |
Receives reassigned benefits from 1 practitioner Practice locations: Williamstown, NJ |
National Provider Directory
Locations
1035 N Black Horse Pike
Ste 7
Williamstown, NJ 08094
Phone (856) 740-1300
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | 22DIO2212104 | NJ | Yes |
Addresses
Primary practice location
1035 N Black Horse Pike
Suite #7
Williamstown, NJ 08094-2840
Mailing address
1035 N Black Horse Pike
Suite #7
Williamstown, NJ 08094-2840
Phone (856) 740-1300
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- Andrew M Cogan
- Community Health Care, Inc.
- Kristine Coniglio
- Peter Dennis Corda
- Constance M Courduff
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- CPL (Meadowview) LLC
All providers in Williamstown, NJ · Clinic/Center in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 2, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.