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NPI Code Detail

MEDICARE: POMPTON CARE, LLC

MEDICARE: POMPTON CARE, 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
1314000000XSkilled Nursing Facility060706NJ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1315036OTHERHORIZON - SNF
2316920OTHERUS FAMILY HEALTH PLAN
3000820OTHERHORIZION - SUB
40004294000OTHERAMERIHEALTH-TRADITIONAL
54476603OTHERNJUNISYS #
623-2261435OTHERCIGNA-NJ
70004294000OTHERAMERIHEALTH-MANAGED CARE
8MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
92176496OTHERAETNA-HMO

General Provider Information

NPI Number : 1710931787
Entity Type Code : Organization
Provider Name (Legal Business Name) : POMPTON CARE, LLC
Provider Business Mailing Address
First Line : 101 E STATE ST
Second Line :
City : KENNETT SQUARE
State : PA
Zip : 19348-3109
Country : US
Telephone Number : 610-925-4436
Fax Number : 610-925-4351
Provider Business Practice Location Address
First Line : 25 E LINDSLEY RD
Second Line :
City : CEDAR GROVE
State : NJ
Zip : 07009-1023
Country : US
Telephone Number : 973-256-7220
Fax Number : 973-256-4723
Authorized Official
Title or Position : CORPORATE MANAGER
Name : JANE DROPESKEY
Credential :
Telephone Number : 610-925-4231
Provider Enumeration Date : 05/22/2006
Last Update Date : 08/17/2018

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