Healthcare Provider Details

I. General information

NPI: 1679974174
Provider Name (Legal Business Name): RUNNELLS BH OPERATING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2014
Last Update Date: 08/26/2024
Certification Date: 08/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 WATCHUNG WAY
BERKELEY HEIGHTS NJ
07922-2600
US

IV. Provider business mailing address

49 HAMLIN RD
EDISON NJ
08817-2951
US

V. Phone/Fax

Practice location:
  • Phone: 718-360-8083
  • Fax: 718-732-2481
Mailing address:
  • Phone: 718-360-8083
  • Fax: 718-732-2481

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282E00000X
TaxonomyLong Term Care Hospital
License Number22001
License Number StateNJ

VIII. Authorized Official

Name: JONATHAN ROSENBERG
Title or Position: MANAGING MEMBER
Credential:
Phone: 732-335-6951