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NPI Code Detail

MEDICARE: INDEPENDENT HOME CARE

MEDICARE: INDEPENDENT HOME CARE
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
1163W00000XRegistered Nurse
2251T00000XPACE Provider Organization
3364SA2200XAdult Health Clinical Nurse Specialist
4364SH0200XHome Health Clinical Nurse Specialist
5372600000XAdult Companion
6374U00000XHome Health Aide
7376J00000XHomemaker
8376K00000XNurse's Aide
9385H00000XRespite Care
10251E00000XHome Health Agency

General Provider Information

NPI Number : 1457915126
Entity Type Code : Organization
Provider Name (Legal Business Name) : INDEPENDENT HOME CARE
Provider Business Mailing Address
First Line : 20 COMMERCE DR STE 135
Second Line :
City : CRANFORD
State : NJ
Zip : 07016-3614
Country : US
Telephone Number : 908-603-6277
Fax Number : 516-706-0839
Provider Business Practice Location Address
First Line : 20 COMMERCE DR STE 135
Second Line :
City : CRANFORD
State : NJ
Zip : 07016-3614
Country : US
Telephone Number : 908-603-6277
Fax Number : 516-706-0839
Authorized Official
Title or Position : OWNER
Name : CATHERINE DERENONCOURT
Credential : RN
Telephone Number : 908-603-6277
Provider Enumeration Date : 04/27/2019
Last Update Date : 04/27/2019

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Directions to “INDEPENDENT HOME CARE ” Practice Location

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