Healthcare Provider Details

I. General information

NPI: 1528125739
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

113 WHITE HORSE RD W STE 9
VOORHEES NJ
08043-3671
US

IV. Provider business mailing address

113 WHITE HORSE RD W STE 9
VOORHEES NJ
08043-3671
US

V. Phone/Fax

Practice location:
  • Phone: 856-783-0312
  • Fax: 856-783-8049
Mailing address:
  • Phone: 856-783-0312
  • Fax: 856-783-8049

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHP0016211
License Number StateNJ

VIII. Authorized Official

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