Healthcare Provider Details

I. General information

NPI: 1831292259
Provider Name (Legal Business Name): MUHLENBERG REGIONAL MEDICAL CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/07/2006
Last Update Date: 12/14/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 PARK AVE & RANDOLPH RD
PLAINFIELD NJ
07060-3300
US

IV. Provider business mailing address

1200 PARK AVE & RANDOLPH RD
PLAINFIELD NJ
07060-3300
US

V. Phone/Fax

Practice location:
  • Phone: 732-632-1571
  • Fax: 732-632-1644
Mailing address:
  • Phone: 732-632-1571
  • Fax: 732-632-1644

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number72001
License Number StateNJ

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier0L0554
Identifier TypeOTHER
Identifier StateNJ
Identifier IssuerHEALTHNET
# 2
Identifier50302
Identifier TypeOTHER
Identifier StateNJ
Identifier IssuerAMERIGROUP
# 3
Identifier317059
Identifier TypeOTHER
Identifier StateNJ
Identifier IssuerAETNA
# 4
IdentifierUN000013700
Identifier TypeOTHER
Identifier StateNJ
Identifier IssuerAMERICHOICE
# 5
Identifier1091631
Identifier TypeOTHER
Identifier StateNJ
Identifier IssuerHORIZON MERCY OF NJ
# 6
Identifier317059
Identifier TypeOTHER
Identifier StateNJ
Identifier IssuerNJ HORIZON BCBS
# 7
Identifier3691004
Identifier TypeMEDICAID
Identifier StateNJ
Identifier Issuer
# 8
Identifier38831
Identifier TypeOTHER
Identifier StateNJ
Identifier IssuerUNIVERSITY HEALTH PLAN

VIII. Authorized Official

Name: MR. JOHN P MCGEE
Title or Position: PRESIDENT AND CEO
Credential:
Phone: 732-632-1501