BROADWAY COMMUNITY HEALTH CARE, INC (NPI# 1386984763) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386984763 |
| Entity Type | Organization |
| Organization Name | BROADWAY COMMUNITY HEALTH CARE, INC |
| Practice Address |
442 S Broadway Camden NJ 08103-1246 |
| Practice Telephone | 8563651707 |
| Practice Fax Number | 8563651737 |
| Mailing Telephone | 8563651707 |
| Mailing Fax Number | 8563651737 |
| Enumeration Date | 2013-02-22 |
| Last Update Date | 2013-06-24 |
| Authorized Official Name | DR. PATRICK AIME ERVILUS (PROVIDER) |
| Authorized Official Telephone | 8563651707 |
| Authorized Official Credential | PHD, FNP-C, PMHN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
26NN10322000 | NJ | Ambulatory Health Care Facilities |
| Street Address |
442 S BROADWAY |
| City | CAMDEN |
| State | NJ |
| Zip Code | 08103-1246 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912516063 | Toni Marie Primas | Registered Nurse | Sheridan Pavilion, Three Cooper Plaza Suite 220, Camden, NJ 08103 | 2020-07-24 |
| 1376028548 | Services To Overcome Drug Abuse Among Teenagers, Inc. | Clinic/Center | 805-815 Federal Street, Camden, NJ 08103 | 2018-10-03 |
| 1942795802 | Kyle Richard Marden | Student in an Organized Health Care Education/Training Program | 401 Haddon Avenue, 2nd Floor Room 266, Camden, NJ 08103 | 2018-06-24 |
| 1588157473 | Julio Antonio Rodriguez Jr. | Student in an Organized Health Care Education/Training Program | Cooper University Hospital, 3 Cooper Plaza Suite 408, Camden, NJ 08103 | 2018-06-14 |
| 1386149748 | Shuchi Gupta | Nurse Practitioner | 519 West Street, Camden, NJ 08103 | 2018-03-28 |
| 1326541491 | Bolanle Idowu-akangbe | Nurse Practitioner | 519-525 West Street, Camden, NJ 08103 | 2018-03-14 |
| 1740709500 | New Beginnings Behavioral Health | Clinic/Center | 1300 Princess Avenue, Camden, NJ 08103 | 2017-09-13 |
| 1760905012 | Loraine Morris | Counselor | 1479 Kaighn Ave, Camden, NJ 08103 | 2017-07-19 |
| 1386164333 | Matthew Share | Genetic Counselor, MS | Two Cooper Plaza, 400 Haddon Avenue, Md Anderson Cancer Center, Camden, NJ 08103 | 2017-06-21 |
| 1568902070 | Cooper University Hospital | General Acute Care Hospital | 1 Cooper Plaza, Dorrance 222, Camden, NJ 08103 | 2017-03-02 |
| Find all providers in zip 08103 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316580632 | R-health Primary Care Medical Home LLC | Clinic/Center | 2 Cooper St, Camden, NJ 08102-2348 | 2019-10-18 |
| 1437371093 | Delaware Family Healthcare Alliance, Inc. | Clinic/Center | 2114 S Dupont Hwy Ste 1, Camden, DE 19934-1249 | 2007-05-03 |
| 1427025576 | J. Paul Jones Hospital Board Wilcox Medical Clinic | Clinic/Center | 319 Mcwilliams Ave, Camden, AL 36726-1610 | 2006-03-07 |
| 1043825110 | Premier Family Medicine, LLC | Clinic/Center | 1493 Highway 17, Camden, MS 39045-9524 | 2020-09-14 |
| 1316401557 | J Paul Jones Hospital Primary Care Clinic | Clinic/Center | 321 Whiskey Run Rd, Camden, AL 36726-2303 | 2019-01-22 |
| 1891113965 | Rome Memorial Hospital, Inc | Clinic/Center | 5 Masonic Ave, Camden, NY 13316-1234 | 2014-04-04 |
| 1912325077 | Leap Health and Wellness Center | Clinic/Center | 130 N Broadway, 10th Floor, Camden, NJ 08102-1122 | 2014-04-04 |
| 1750651857 | Ouachita Physician Services | Clinic/Center | 476 Hospital Dr, Camden, AR 71701-4616 | 2012-01-05 |
| 1801178207 | Ramon Acosta Md PC | Clinic/Center | 2 Leonard Ave, Camden, NJ 08105-2404 | 2011-09-13 |
| 1386951101 | Thornburg Family Medical Clinic, Inc | Clinic/Center | 160 Hospital Dr, Camden, TN 38320-1618 | 2010-09-01 |
| Find all providers in CAMDEN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.