Provider Demographics
NPI:1306872296
Name:WILLIAM B. KESSLER MEMORIAL HOSPITAL
Entity type:Organization
Organization Name:WILLIAM B. KESSLER MEMORIAL HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:INTERIM CEO
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:M
Authorized Official - Last Name:ROSSI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-561-6700
Mailing Address - Street 1:600 S WHITE HORSE PIKE
Mailing Address - Street 2:
Mailing Address - City:HAMMONTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08037-2099
Mailing Address - Country:US
Mailing Address - Phone:609-561-6700
Mailing Address - Fax:609-704-1269
Practice Address - Street 1:600 S WHITE HORSE PIKE
Practice Address - Street 2:
Practice Address - City:HAMMONTON
Practice Address - State:NJ
Practice Address - Zip Code:08037-2099
Practice Address - Country:US
Practice Address - Phone:609-561-6700
Practice Address - Fax:609-704-1269
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-23
Last Update Date:2008-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ10104282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0001227000OtherAMERIHEALTH/KEYSTONE BC
NY00434244Medicaid
NJ0478212OtherCIGNA
NJ35891OtherUNITED HEALTHCARE
NJJ004637OtherCHAMPUS - TRICARE
GA300003269AMedicaid
NJ3676404Medicaid
NJ50301OtherAMERIGROUP
NJIL5511OtherACS/HEALTHNET
NJ13063OtherAETNA US HEALTHCARE
NJ01000419500OtherAMERICHOICE
NJ23418OtherUNIVERSITY HEALTH PLAN
NJ5361303Medicaid
FL912671600Medicaid
NJ45564OtherHORIZON NJ
NJHO5100OtherOXFORD
NJ310088Medicare ID - Type Unspecified
GA300003269AMedicaid