1336394295 NPI number — CARE ONE AT STANWICK, LLC

Table of content: (NPI 1336394295)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1336394295 NPI number — CARE ONE AT STANWICK, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CARE ONE AT STANWICK, 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:
CARO ONE HARMONY VILLAGE AT MOORESTOWN
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:
1336394295
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/13/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
301 N. STANWICK RD.
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MOORESTOWN
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08057
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
856-638-1244
Provider Business Mailing Address Fax Number:
856-638-1289

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
301 N. STANWICK RD.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MOORESTOWN
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08057
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
856-638-1244
Provider Business Practice Location Address Fax Number:
856-638-1289
Provider Enumeration Date:
11/19/2008

Additional Information

Authorized Official

Authorized Official Last Name:
LUGO
Authorized Official First Name:
A.
Authorized Official Middle Name:
ALBERTO
Authorized Official Title or Position:
EXECUTIVE VP & GENERAL COUNSEL
Authorized Official Telephone Number:
201-242-4000

Provider Taxonomy Codes

  • Taxonomy code: 310400000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2024 www.npivalidator.com