MEDICARE: ELDERLY CARE SOLUTIONS, LLC

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	HP0161900	NJ

General Provider Information

NPI Number	:	1417222308
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELDERLY CARE SOLUTIONS, LLC

Provider Business Mailing Address
First Line	:	9 BALMY CT
Second Line	:
City	:	MOUNT ROYAL
State	:	NJ
Zip	:	08061-1074
Country	:	US
Telephone Number	:	856-468-5332
Fax Number	:	856-468-5332

Provider Business Practice Location Address
First Line	:	9 BALMY CT
Second Line	:
City	:	MOUNT ROYAL
State	:	NJ
Zip	:	08061
Country	:	US
Telephone Number	:	856-468-5098
Fax Number	:	856-458-5332

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICER
Name	:	MR. ALEXANDER S MARTINEZ
Credential	:
Telephone Number	:	856-468-5332

Provider Enumeration Date	:	03/12/2012
Last Update Date	:	03/12/2012

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