1174520076 NPI number — VNA HEALTH GROUP OF NEW JERSEY, LLC

Table of content: (NPI 1174520076)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1174520076 NPI number — VNA HEALTH GROUP OF NEW JERSEY, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
VNA HEALTH GROUP OF NEW JERSEY, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
BARNABAS HEALTH HOME CARE AND HOSPICE
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1174520076
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/08/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
23 MAIN STREET
Provider Second Line Business Mailing Address:
SUITE D1
Provider Business Mailing Address City Name:
HOLMDEL
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07733-2136
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
732-224-6914
Provider Business Mailing Address Fax Number:
732-784-9710

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
80 MAIN STREET - SUITE 300
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WEST ORANGE
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07052-4850
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
973-243-9666
Provider Business Practice Location Address Fax Number:
732-784-9901
Provider Enumeration Date:
07/07/2005

Additional Information

Authorized Official

Authorized Official Last Name:
GAYLORD
Authorized Official First Name:
PETER
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIEF FINANCIAL OFFICER
Authorized Official Telephone Number:
800-862-3330

Provider Taxonomy Codes

  • Taxonomy code: 251G00000X , with the licence number:  22714,24416,22634 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251G00000X , with the licence number: 22714 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 251G00000X , with the licence number: 24416 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251G00000X , with the licence number: 22634 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0557153 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0L0684 . This is a "HEALTH NET" identifier . This identifiers is of the category "OTHER".
  • Identifier: 13615 . This is a "UNIVERSITY HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 22634 . This is a "HOSPICE LICENSES" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 8426225 . This is a "AETNA/USHC" identifier . This identifiers is of the category "OTHER".
  • Identifier: F07459 . This is a "CCS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1014126 . This is a "HORIZON/NJ HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 22714 . This is a "HOSPICE LICENSES" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: ANC709 . This is a "OXFORD HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 004218 . This is a "AMERIHEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0042545 . This is a "AETNA/USHC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 24416 . This is a "HOSPICE LICENSES" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 88760 . This is a "AMERIGROUP" identifier . This identifiers is of the category "OTHER".




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