MEDICARE: CARE ONE AT MERCER, 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	314000000X	Skilled Nursing Facility	476003	NJ

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	:	1497754188
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARE ONE AT MERCER, LLC

Provider Business Mailing Address
First Line	:	1201 PARKWAY AVE
Second Line	:
City	:	EWING
State	:	NJ
Zip	:	08628-3008
Country	:	US
Telephone Number	:	609-882-6900
Fax Number	:	609-671-3910

Provider Business Practice Location Address
First Line	:	1201 PARKWAY AVE
Second Line	:
City	:	EWING
State	:	NJ
Zip	:	08628-3008
Country	:	US
Telephone Number	:	609-882-6900
Fax Number	:	609-671-3910

Authorized Official
Title or Position	:	EXECUTIVE VP
Name	:	MR. KEVIN P BRESLIN
Credential	:
Telephone Number	:	201-242-4004

Provider Enumeration Date	:	07/15/2005
Last Update Date	:	08/22/2020

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Directions to “CARE ONE AT MERCER, LLC ” Practice Location

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