Organization
INDEPENDENCE REHAB SERVICES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHIRVELL M THOMAS (CHIEF OPERATING OFFICER)
(856) 321-1900
Entity
Organization
Contact information
Practice address
1030 KINGS HWY N, SUITE 210, CHERRY HILL, NJ 08034-1907
(856) 321-1900
(856) 321-1107
Mailing address
1030 KINGS HWY N, SUITE 210, CHERRY HILL, NJ 08034-1907
(856) 321-1900
(856) 321-1107
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
316628
HORIZON BCBS
NJ
01
—
525894
AETNA USHEALTHCARE
NJ
05
—
6337601
—
NJ
Enumeration date
05/23/2006
Last updated
03/03/2011
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