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General NPI Number Information
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NPI Number | 1043208606
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Entity Type | Organization
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Legal Business Name | SHORE HEALTH SERVICES CORPORATION
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Dates
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Enumeration Date | 10/07/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 555 BAY AVE
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City | SOMERS POINT
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State | NJ
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Zip | 08244-2533
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Country | US
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Telephone | 609-927-9151
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Fax | 609-601-6472
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Provider Business Mailing Address
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Address Line | 555 BAY AVE
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City | SOMERS POINT
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State | NJ
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Zip | 08244-2533
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Country | US
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Telephone | 609-927-9151
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Fax | 609-601-6472
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Authorized Official
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Title or Position | CONTROLLER
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Name | MR. KEVIN P SLOAN
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Credential |
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Telephone | 609-927-9151
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 060109
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License Number State | NJ
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