Healthcare Provider Details

I. General information

NPI: 1932154523
Provider Name (Legal Business Name): HOOSIER CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2006
Last Update Date: 06/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1515 HULSE RD
POINT PLEASANT BEACH NJ
08742-4527
US

IV. Provider business mailing address

1050 CHINOE RD STE 350
LEXINGTON KY
40502-6571
US

V. Phone/Fax

Practice location:
  • Phone: 732-295-9300
  • Fax: 732-295-8781
Mailing address:
  • Phone: 859-255-0075
  • Fax: 859-281-5150

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number061502
License Number StateNJ

VIII. Authorized Official

Name: BRENDA CAMPBELL
Title or Position: AR BILLING MANAGER
Credential:
Phone: 859-255-0075