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Organization

OUR LADY OF LOURDES MEDICAL CENTER

Active
Other names
Lourdes Mt. Laurel Dialysis Unit
Organization subpart
No

Provider details

NPI number
Authorized official
MR. ANDREW GUARNI (CFO)
(856) 824-3131
Entity
Organization

Contact information

Practice address
130 GAITHER DR, SUITE 172, MOUNT LAUREL, NJ 08054-1715
(856) 757-3776
Mailing address
100 FRONT ST, RIVERSIDE, NJ 08075-1181

Taxonomy

Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
10404
NJ

Other

Enumeration date
08/24/2005
Last updated
12/07/2007
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