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Organization
PRIME HEALTHCARE SERVICES - ST MICHAELS LLC
Active
Organization
PRIME HEALTHCARE SERVICES - ST MICHAELS LLC
Active
Other names
Saint Michael's Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER DOAN (CHIEF COMPLIANCE COUNSEL)
(909) 235-4307
Entity
Organization
Contact information
Practice address
111 CENTRAL AVE, NEWARK, NJ 07102-1909
(973) 877-2853
(973) 877-5367
Mailing address
111 CENTRAL AVE, NEWARK, NJ 07102-1909
(973) 877-2853
(973) 877-5367
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
10713
NJ
273R00000X
Psychiatric Hospital Unit
10713
NJ
282N00000X
General Acute Care Hospital
Primary
10713
NJ
Other
Enumeration date
03/29/2016
Last updated
03/29/2016
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