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NPI Code Detail

MEDICARE: NORTH BERGEN HEALTHCARE, LLC

MEDICARE: NORTH BERGEN HEALTHCARE, 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 Facility060902NJ

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 : 1780775635
Entity Type Code : Organization
Provider Name (Legal Business Name) : NORTH BERGEN HEALTHCARE, LLC
Provider Business Mailing Address
First Line : 9020 WALL ST
Second Line :
City : NORTH BERGEN
State : NJ
Zip : 07047-6011
Country : US
Telephone Number : 201-809-2890
Fax Number :
Provider Business Practice Location Address
First Line : 9020 WALL ST
Second Line :
City : NORTH BERGEN
State : NJ
Zip : 07047-6011
Country : US
Telephone Number : 201-861-4040
Fax Number :
Authorized Official
Title or Position : ADMINISTRATOR
Name : MR. HARRY WRUBLE
Credential :
Telephone Number : 201-809-2890
Provider Enumeration Date : 09/27/2006
Last Update Date : 06/18/2008

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