OUR LADY OF LOURDES MEDICAL CENTER, INC (NPI# 1992798995) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1992798995 |
Entity Type | Organization |
Organization Name | OUR LADY OF LOURDES MEDICAL CENTER, INC |
Practice Address |
1600 Haddon Ave Camden NJ 08103-3101 |
Mailing Address |
100 Front Street Riverside NJ 08075 |
Practice Telephone | 8567573776 |
Mailing Telephone | 8568243460 |
Enumeration Date | 2005-08-24 |
Last Update Date | 2018-01-05 |
Authorized Official Name | MR. ANDREW GUARNI (CFO) |
Authorized Official Telephone | 8568243131 |
Authorized Official Credential | CPA |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QE0700X |
Clinic/Center Specialization: End-Stage Renal Disease (ESRD) Treatment |
10404 | NJ | Ambulatory Health Care Facilities |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1811020654 | Our Lady of Lourdes Medical Center, Inc | Family Medicine | 900 Haddon Ave, Suite 136, Collingswood, NJ 08108-2101 | 2007-03-13 |
Street Address |
1600 HADDON AVE |
City | CAMDEN |
State | NJ |
Zip Code | 08103-3101 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1851399455 | Christina M Lamonica | Specialist | 1600 Haddon Ave, Camden, NJ 08103-3101 | 2005-07-08 |
1992306781 | Eric Rayburn | Nurse Practitioner | 1600 Haddon Ave, Camden, NJ 08103-3101 | 2020-11-06 |
1508476177 | Georgeanne V Stilley | Clinical Nurse Specialist | 1600 Haddon Ave, Camden, NJ 08103-3101 | 2020-08-07 |
1871125013 | Vanessa Lynn Klemas | Specialist/Technologist, Other | 1600 Haddon Ave, Camden, NJ 08103-3101 | 2020-02-05 |
1457991903 | Idan Waksman | Physician Assistant | 1600 Haddon Ave, Camden, NJ 08103-3101 | 2020-01-13 |
1154964716 | Jaclyn Palmisano | Nurse Practitioner | 1600 Haddon Ave, Camden, NJ 08103-3101 | 2019-10-25 |
1538702642 | David Shaw | Anesthesiology | 1600 Haddon Ave, Camden, NJ 08103-3101 | 2019-10-21 |
1215588462 | Victoria Clark | Advanced Practice Midwife | 1600 Haddon Ave, Camden, NJ 08103-3101 | 2019-09-27 |
1215401120 | Lindsay Szczerbinski | Nurse Anesthetist, Certified Registered | 1600 Haddon Ave, Camden, NJ 08103-3101 | 2019-01-14 |
1366919789 | Kassandre King | Nurse Anesthetist, Certified Registered | 1600 Haddon Ave, Camden, NJ 08103-3101 | 2018-10-24 |
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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 |
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Taxonomy Code | 261QE0700X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | End-Stage Renal Disease (ESRD) Treatment |
Definition to come... |
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1891039210 | Renal Treatment Centers Southeast Lp | Clinic/Center | 1114 W Washington St Nw, Camden, AR 71701-3827 | 2012-11-26 |
1457463218 | Bio-medical Applications of Alabama Inc. | Clinic/Center | 229 Camden Byp, Camden, AL 36726-2217 | 2006-08-31 |
1801813548 | Bio-medical Applications of South Carolina, Inc. | Clinic/Center | 7 Haile Ln, Camden, SC 29020-3754 | 2006-07-17 |
1164484770 | Total Renal Care Inc | Clinic/Center | 168 W Main St Ste A, Camden, TN 38320-1767 | 2006-04-06 |
1114992047 | Arkansas Nephrology Services, Ltd. | Clinic/Center | 1114 Washington N.w., Camden, AR 71701-3827 | 2006-02-22 |
1891044756 | Tyler Dialysis LLC | Clinic/Center | 1601 Haddon Ave, Camden, NJ 08103-3109 | 2012-09-06 |
1942450325 | Fresenius Medical Care Cna Kidney Centers, LLC | Clinic/Center | 7 Haile Ln, Camden, SC 29020-3754 | 2008-09-23 |
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1356963938 | Usrc Gloucester, LLC | Clinic/Center | 601 Berlin Cross Keys Rd, Sicklerville, NJ 08081-9563 | 2020-05-18 |
1679192876 | Knickerbocker Dialysis Inc | Clinic/Center | 1734 Hancock St, Ridgewood, NJ 11385-4734 | 2020-04-09 |
1750910295 | Elandon Dialysis LLC | Clinic/Center | 820 N Rte 17, Paramus, NJ 07652-3104 | 2020-04-06 |
1780212365 | Zellier Dialysis LLC | Clinic/Center | 1260 Route 22 E, North Plainfield, NJ 07060 | 2020-03-30 |
1437798386 | Total Renal Care Inc | Clinic/Center | 1800 State Route 34 Ste 302, Wall Township, NJ 07719-9146 | 2019-12-24 |
1598306276 | Fresenius Medical Care Passaic, LLC | Clinic/Center | 10 Clifton Blvd Ste 1, Clifton, NJ 07011-3802 | 2019-10-03 |
1821646035 | Isd Renal Inc | Clinic/Center | 262 Broad St, Newark, NJ 07104-3809 | 2019-08-30 |
1699323824 | Claymount Dialysis LLC | Clinic/Center | 21 Cornwell Dr, Bridgeton, NJ 08302-3632 | 2019-08-30 |
1962064758 | Fresenius Medical Care Bridgeton, LLC | Clinic/Center | 12 Cornwell Dr, Bridgeton, NJ 08302-3633 | 2019-07-02 |
1790347698 | Wellbound of Cherry Hill, LLC | Clinic/Center | 1945 Route 70 E Ste A, Cherry Hill, NJ 08003-2117 | 2019-07-01 |
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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.