Organization
KENNEDY HEALTH FACILITIES, INC.
Active
Other names
Kennedy Health Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICHARD KOSS (VICE PRESIDENT, AMBULATORY SERVICES)
(856) 566-5279
Entity
Organization
Contact information
Practice address
535 EGG HARBOR RD, SEWELL, NJ 08080-2335
(856) 582-3170
(856) 582-3143
Mailing address
535 EGG HARBOR RD, SEWELL, NJ 08080-2335
(856) 582-3170
(856) 582-3143
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
060806
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000591100
INDEPENDENCE BLUE CROSS
PA
01
—
13145
AETNA USHEALTHCARE
NJ
01
—
315231
HORIZON BLUE CROSS
NJ
05
—
4478304
—
NJ
01
—
612914300
FEDERAL BLACK LUNG
FL
Enumeration date
09/06/2005
Last updated
06/29/2012
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