=====================================================
General NPI Number Information
=====================================================
NPI Number | 1871391193
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | EMEREST CERTIFIED HOME HEALTH CARE OF SOUTH JERSEY LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/04/2025
-----------------------------------------------------
Last Update Date | 04/30/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 300 HARPER DR
-----------------------------------------------------
City | MOORESTOWN
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08057-3208
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 856-552-1300
-----------------------------------------------------
Fax | 856-552-1307
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 300 HARPER DR
-----------------------------------------------------
City | MOORESTOWN
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08057-3208
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 856-552-1300
-----------------------------------------------------
Fax | 856-552-1307
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CHIEF ADMINISTRATIVE OFFICER
-----------------------------------------------------
Name | MR. JOSEPH KATZ
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 718-475-1000
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------