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NPI Code Detail

MEDICARE: 600 KINDERKAMACK ROAD OPERATING COMPANY, LLC

MEDICARE: 600 KINDERKAMACK ROAD OPERATING COMPANY, 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 Facility060234NJ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1760481444
Entity Type Code : Organization
Provider Name (Legal Business Name) : 600 KINDERKAMACK ROAD OPERATING COMPANY, LLC
Provider Business Mailing Address
First Line : 600 KINDERKAMACK ROAD
Second Line :
City : ORADELL
State : NJ
Zip : 07649
Country : US
Telephone Number : 201-967-0002
Fax Number : 201-967-8774
Provider Business Practice Location Address
First Line : 600 KINDERKAMACK ROAD
Second Line :
City : ORADELL
State : NJ
Zip : 07649
Country : US
Telephone Number : 201-967-0002
Fax Number : 201-967-8774
Authorized Official
Title or Position : EXECUTIVE VP & GENERAL COUNSEL
Name : MR. A. ALBERTO LUGO
Credential :
Telephone Number : 201-242-4000
Provider Enumeration Date : 07/15/2005
Last Update Date : 08/13/2015

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Directions to “600 KINDERKAMACK ROAD OPERATING COMPANY, LLC ” Practice Location

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