MEDICARE: HOLY REDEEMER VISITING NURSE AGENCY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency	70502	NJ

General Provider Information

NPI Number	:	1063486108
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOLY REDEEMER VISITING NURSE AGENCY

Provider Business Mailing Address
First Line	:	6550 DELILAH RD
Second Line	:	SUITE 501
City	:	EGG HARBOR TOWNSHIP
State	:	NJ
Zip	:	08234-5102
Country	:	US
Telephone Number	:	609-761-0300
Fax Number	:	609-761-3294

Provider Business Practice Location Address
First Line	:	6550 DELILAH RD
Second Line	:	SUITE 501
City	:	EGG HARBOR TOWNSHIP
State	:	NJ
Zip	:	08234-5102
Country	:	US
Telephone Number	:	609-761-0300
Fax Number	:	609-761-3294

Authorized Official
Title or Position	:	VP FINANCE
Name	:	MR. GEORGE W HAMILTON
Credential	:
Telephone Number	:	215-698-3726

Provider Enumeration Date	:	02/15/2006
Last Update Date	:	02/07/2024

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