MEDICARE: SHORE HEALTH CARE CENTER, 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	314000000X	Skilled Nursing Facility	061536	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	:	1669568895
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SHORE HEALTH CARE CENTER, INC.

Provider Business Mailing Address
First Line	:	527 RIVER AVE
Second Line	:
City	:	LAKEWOOD
State	:	NJ
Zip	:	08701-4722
Country	:	US
Telephone Number	:	732-905-0700
Fax Number	:	732-905-3382

Provider Business Practice Location Address
First Line	:	527 RIVER AVE
Second Line	:
City	:	LAKEWOOD
State	:	NJ
Zip	:	08701-4722
Country	:	US
Telephone Number	:	732-905-0700
Fax Number	:	732-905-3382

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. BENZION SCHACHTER
Credential	:	LNHA
Telephone Number	:	732-905-0700

Provider Enumeration Date	:	10/05/2006
Last Update Date	:	12/10/2007

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