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General NPI Number Information
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NPI Number | 1548244627
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Entity Type | Organization
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Legal Business Name | SALEM COUNTY NURSING HOME
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Dates
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Enumeration Date | 12/02/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 438 WOODSTOWN RD.
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City | SALEM
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State | NJ
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Zip | 08079
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Country | US
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Telephone | 856-395-6677
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Fax |
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Provider Business Mailing Address
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Address Line | 438 WOODSTOWN RD.
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City | SALEM
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State | NJ
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Zip | 08079
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Country | US
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Telephone | 856-395-6677
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | DOUGLAS POWNALL
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Credential |
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Telephone | 856-395-6677
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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 | 061703
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License Number State | NJ
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