MEDICARE: EMERALD HEALTH CARE SERVICES, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency	HP0141300	NJ
2	251J00000X	Nursing Care Agency	HP0141300	NJ
3	261QS1200X	Sleep Disorder Diagnostic Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1134190994
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EMERALD HEALTH CARE SERVICES, INC.

Provider Business Mailing Address
First Line	:	6 PARKSIDE LN
Second Line	:
City	:	KINNELON
State	:	NJ
Zip	:	07405-2500
Country	:	US
Telephone Number	:	973-930-4245
Fax Number	:	973-283-1507

Provider Business Practice Location Address
First Line	:	6 PARKSIDE LN
Second Line	:
City	:	KINNELON
State	:	NJ
Zip	:	07405-2500
Country	:	US
Telephone Number	:	973-930-4245
Fax Number	:	973-283-1507

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. KEVIN KELLY
Credential	:
Telephone Number	:	973-930-4245

Provider Enumeration Date	:	01/30/2006
Last Update Date	:	11/04/2020

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Directions to “EMERALD HEALTH CARE SERVICES, INC. ” Practice Location

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