Healthcare Provider Details

I. General information

NPI: 1992862361
Provider Name (Legal Business Name): INTERIM HEALTHCARE MANAGED SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2007
Last Update Date: 04/10/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1873 BRUNSWICK AVENUE
TRENTON NJ
08638-0043
US

IV. Provider business mailing address

1466 HOOPER AVE
TOMS RIVER NJ
08753-2827
US

V. Phone/Fax

Practice location:
  • Phone: 609-393-4545
  • Fax:
Mailing address:
  • Phone: 732-341-0330
  • Fax: 732-341-2269

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHP0016204
License Number StateNJ

VIII. Authorized Official

Name: MS. JACQUELINE BARTORELLI
Title or Position: VICE PRESIDENT OF OPERATIONS
Credential:
Phone: 609-393-4545