1790789212 NPI number — AHS HOSPITAL CORP

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1790789212 NPI number — AHS HOSPITAL CORP

Employer Identification Number (EIN):

Provider Organization Name:

AHS HOSPITAL CORP

Provider Last Name:

Provider First Name:

Provider Middle Name:

Provider Name Prefix Text:

Provider Name Suffix Text:

Provider Credential Text:

Provider Gender Code:

Provider Other Organization Name:

NEWTON MEDICAL CENTER

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:

1790789212

Entity Type Code:

Organization

Replacement NPI:

Last Update Date:

02/23/2023

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

475 SOUTH ST

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:

MORRISTOWN

Provider Business Mailing Address State Name:

NJ

Provider Business Mailing Address Postal Code:

07960-6459

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

Provider Business Mailing Address Fax Number:

Provider First Line Business Practice Location Address:

175 HIGH ST

Provider Second Line Business Practice Location Address:

Provider Business Practice Location Address City Name:

NEWTON

Provider Business Practice Location Address State Name:

NJ

Provider Business Practice Location Address Postal Code:

07860-1004

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

973-383-2121

Provider Business Practice Location Address Fax Number:

973-383-9355

Provider Enumeration Date:

06/13/2005

Authorized Official Last Name:

LENAHAN

Authorized Official First Name:

KEVIN

Authorized Official Middle Name:

J

Authorized Official Title or Position:

VP/CFO

Authorized Official Telephone Number:

973-660-3190

• Taxonomy code: 273R00000X , with the licence number:  11902 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 282N00000X , with the licence number: 11902 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 00410820 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
• Identifier: 0263214 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
• Identifier: XHSP43600 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
• Identifier: 091245000 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
• Identifier: 3100028 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
• Identifier: 0257109 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
• Identifier: 4550102 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
• Identifier: 7200706 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
• Identifier: 49056557 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".
• Identifier: NEW0028N , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
• Identifier: 0258024 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
• Identifier: 200256690A , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".
• Identifier: 40-4703831 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".
• Identifier: 0040986 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
• Identifier: 334095 , issued by the state of ( AZ ) . This identifiers is of the category "MEDICAID".
• Identifier: 003040458 , issued by the state of ( CT ) . This identifiers is of the category "MEDICAID".
• Identifier: 01400365 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
• Identifier: 0450088 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
• Identifier: 4137001 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
• Identifier: 110436500 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".