| Jack C. Wu, M.d. P.a. | |
|
219 Highland Ave Westville NJ 08093-1014 | |
| (856) 456-1881 | |
| (856) 456-3959 |
| Full Name | Jack C. Wu, M.d. P.a. |
|---|---|
| Speciality | Family Medicine |
| Location | 219 Highland Ave, Westville, New Jersey |
| Authorized Official Name and Position | Kevin Wu (PRESIDENT) |
| Authorized Official Contact | 8564561881 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jack C. Wu, M.d. P.a. 219 Highland Ave Westville NJ 08093-1014 Ph: (856) 456-1881 | Jack C. Wu, M.d. P.a. 219 Highland Ave Westville NJ 08093-1014 Ph: (856) 456-1881 |
| NPI Number | 1396843777 |
|---|---|
| Provider Enumeration Date | 09/20/2006 |
| Last Update Date | 07/14/2022 |
| Medicare PECOS PAC ID | 2365457488 |
|---|---|
| Medicare Enrollment ID | O20060210000470 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396843777 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 25MB07468500 (New Jersey) | Primary |
| 305R00000X | Preferred Provider Organization | 25MA298330 (New Jersey) | Secondary |
| Provider Name | Kevin Wu |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043274228 PECOS PAC ID: 4284663790 Enrollment ID: I20050815000821 |
Evergreen Medical Associates Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1200 Delsea Dr, Suite 10, Westville, NJ 08093 Phone: 856-853-5888 Fax: 215-523-9281 | |
Vid Testing Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 510 Deptford Ave, Westville, NJ 08093 Phone: 267-467-3080 |