Provider Demographics
NPI:1154530624
Name:GENERAL HEALTHCARERESORCES,INC
Entity type:Organization
Organization Name:GENERAL HEALTHCARERESORCES,INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:LPN
Authorized Official - Prefix:MS
Authorized Official - First Name:ELLA
Authorized Official - Middle Name:M
Authorized Official - Last Name:DEVANE
Authorized Official - Suffix:I
Authorized Official - Credentials:NURSE
Authorized Official - Phone:609-348-6479
Mailing Address - Street 1:215 NEW YORK AVE.
Mailing Address - Street 2:A
Mailing Address - City:ATLANTIC CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:08401-0840
Mailing Address - Country:US
Mailing Address - Phone:609-348-6479
Mailing Address - Fax:610-834-7525
Practice Address - Street 1:215 N NEW YORK AVE
Practice Address - Street 2:A
Practice Address - City:ATLANTIC CITY
Practice Address - State:NJ
Practice Address - Zip Code:08401-4463
Practice Address - Country:US
Practice Address - Phone:609-348-6479
Practice Address - Fax:610-834-7525
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NP03186100261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care