Provider Demographics
NPI:1144860271
Name:SENTARUS HEALTHCARE SOLUTIONS INC
Entity type:Organization
Organization Name:SENTARUS HEALTHCARE SOLUTIONS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:BACOTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-696-3132
Mailing Address - Street 1:736 S WHITE HORSE PIKE
Mailing Address - Street 2:
Mailing Address - City:AUDUBON
Mailing Address - State:NJ
Mailing Address - Zip Code:08106-1346
Mailing Address - Country:US
Mailing Address - Phone:215-696-3132
Mailing Address - Fax:215-940-8315
Practice Address - Street 1:736 S WHITE HORSE PIKE
Practice Address - Street 2:
Practice Address - City:AUDUBON
Practice Address - State:NJ
Practice Address - Zip Code:08106-1346
Practice Address - Country:US
Practice Address - Phone:215-696-3132
Practice Address - Fax:215-940-8315
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-07
Last Update Date:2020-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center