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NPI Code Detail

MEDICARE: HACKENSACK MERIDIAN AMBULATORY CARE, INC.

MEDICARE: HACKENSACK MERIDIAN AMBULATORY CARE, 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
1314000000XSkilled Nursing Facility

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2315365OTHERNJMEDICARE

Other Identifiers

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

General Provider Information

NPI Number : 1396256673
Entity Type Code : Organization
Provider Name (Legal Business Name) : HACKENSACK MERIDIAN AMBULATORY CARE, INC.
Provider Business Mailing Address
First Line : 3349 HWY 138 BLDG C
Second Line : SUITE A
City : WALL
State : NJ
Zip : 07719
Country : US
Telephone Number : 732-751-3624
Fax Number :
Provider Business Practice Location Address
First Line : 160 S MAIN ST
Second Line :
City : OCEAN GROVE
State : NJ
Zip : 07756-1013
Country : US
Telephone Number : 732-481-8300
Fax Number :
Authorized Official
Title or Position : SENIOR FINANCE ADMINISTRATION
Name : RICHARD HAND
Credential :
Telephone Number : 732-481-8529
Provider Enumeration Date : 10/13/2017
Last Update Date : 12/27/2021

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