1831292259 NPI number — MUHLENBERG REGIONAL MEDICAL CENTER, INC

Table of content: (NPI 1831292259)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1831292259 NPI number — MUHLENBERG REGIONAL MEDICAL CENTER, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MUHLENBERG REGIONAL MEDICAL CENTER, INC
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:
6
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:
1831292259
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/14/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1200 PARK AVE & RANDOLPH RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PLAINFIELD
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07060-3300
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
732-632-1571
Provider Business Mailing Address Fax Number:
732-632-1644

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1200 PARK AVE & RANDOLPH RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PLAINFIELD
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07060-3300
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
732-632-1571
Provider Business Practice Location Address Fax Number:
732-632-1644
Provider Enumeration Date:
09/07/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MCGEE
Authorized Official First Name:
JOHN
Authorized Official Middle Name:
P
Authorized Official Title or Position:
PRESIDENT AND CEO
Authorized Official Telephone Number:
732-632-1501

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  72001 , 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: 0L0554 . This is a "HEALTHNET" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 50302 . This is a "AMERIGROUP" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 317059 . This is a "AETNA" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: UN000013700 . This is a "AMERICHOICE" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 1091631 . This is a "HORIZON MERCY OF NJ" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 317059 . This is a "NJ HORIZON BCBS" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 3691004 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 38831 . This is a "UNIVERSITY HEALTH PLAN" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".




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