1427084664 NPI number — CARING HOSPICE OF SOUTH JERSEY LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427084664 NPI number — CARING HOSPICE OF SOUTH JERSEY LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CARING HOSPICE OF SOUTH 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:
Provider Other Organization Name Type Code:
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:
1427084664
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/19/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
525 RTE 70 W
Provider Second Line Business Mailing Address:
STE B15
Provider Business Mailing Address City Name:
LAKEWOOD
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08701
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
732-901-6600
Provider Business Mailing Address Fax Number:
732-905-4929

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
133 GAITHER DR STE Q
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MOUNT LAUREL
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08054-1710
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
888-288-2951
Provider Business Practice Location Address Fax Number:
856-439-0318
Provider Enumeration Date:
06/22/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MANSBACH
Authorized Official First Name:
MIRIAM
Authorized Official Middle Name:
Authorized Official Title or Position:
BILLER
Authorized Official Telephone Number:
732-901-6600

Provider Taxonomy Codes

  • Taxonomy code: 251G00000X , with the licence number:  22982 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 7341407 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com