Healthcare Provider Details

I. General information

NPI: 1508424623
Provider Name (Legal Business Name): WOODBURY AMOP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2019
Last Update Date: 08/10/2020
Certification Date: 08/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

467 COOPER ST
WOODBURY NJ
08096-2519
US

IV. Provider business mailing address

515 PLAINFIELD AVE STE 200
EDISON NJ
08817-2506
US

V. Phone/Fax

Practice location:
  • Phone: 856-345-1200
  • Fax:
Mailing address:
  • Phone: 201-953-0546
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: GREG HOOK
Title or Position: EVP COMPLIANCE
Credential:
Phone: 201-953-0546