Organization
LOURDES DIALYSIS AT INNOVA, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER SCHWARTZ (AVP LEGAL SERVICES)
(856) 580-6314
Entity
Organization
Contact information
Practice address
3716 CHURCH RD., MT. LAUREL, NJ 08054-1104
(856) 757-3500
Mailing address
1600 HADDON AVE, CAMDEN, NJ 08103-3101
(856) 757-3500
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
NJ
Other
Enumeration date
11/06/2008
Last updated
11/11/2008
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