Provider Demographics
NPI:1104908078
Name:CARDIAC INTERPRETATION SERVICES, LLC
Entity type:Organization
Organization Name:CARDIAC INTERPRETATION SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:FOX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-795-0099
Mailing Address - Street 1:76 E EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:HADDONFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:08033-2330
Mailing Address - Country:US
Mailing Address - Phone:856-795-0099
Mailing Address - Fax:856-795-9575
Practice Address - Street 1:101 CARNIE BLVD
Practice Address - Street 2:HEART STATION-VIRTUA HEALTH SYSTEM
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-1548
Practice Address - Country:US
Practice Address - Phone:856-325-3492
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8072108Medicaid
NJ8072108Medicaid