Healthcare Provider Details

I. General information

NPI: 1548261688
Provider Name (Legal Business Name): MOORESTOWN VISITING NURSE ASSOCIATION INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2005
Last Update Date: 06/14/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 HARPER DR
MOORESTOWN NJ
08057
US

IV. Provider business mailing address

300 HARPER DR
MOORESTOWN NJ
08057-3208
US

V. Phone/Fax

Practice location:
  • Phone: 856-552-1300
  • Fax: 856-552-1313
Mailing address:
  • Phone: 856-552-1300
  • Fax: 856-552-1313

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number80415
License Number StateNJ

VIII. Authorized Official

Name: MR. SEAN D RABINDRANAUTH
Title or Position: DIRECTOR, IT AND PATIENT ACCOUNTS
Credential:
Phone: 856-552-1300