MEDICARE: GREENVILLE HOSPITAL

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	282N00000X	General Acute Care Hospital	10903	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	310105	OTHER	NJ	HORIZON BLUE CROSS OF NJ
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	HU0000045-02	OTHER	NJ	AMERICHOICE MHS
4	310105	OTHER	NJ	ANTHEM GROUP NEW JERSEY
5	99751	OTHER	NJ	AMERIGROUP AMERICAID
6	H05252	OTHER	NJ	OXFORD
7	1012309	OTHER	NH	HORIZON NJ HLTHCARE MERCY
8	1015734	OTHER	NJ	HORIZON NJ HLTHCARE MERCY
9	0013075	OTHER	NJ	AETNA US HEALTHCARE
10	0004311000	OTHER	NJ	AMERIHEALTH
11	J31132	OTHER	NJ	HEALTH NET PHS
12	1015735	OTHER	NJ	HORIZON NJ HLTHCARE MERCY
13	1015736	OTHER	NJ	HORIZON NJ HLTHCARE MERCY
14	4140702	OTHER	NJ	CHARITY CARE UNYSIS

General Provider Information

NPI Number	:	1871663039
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GREENVILLE HOSPITAL

Provider Business Mailing Address
First Line	:	55 MEADOWLANDS PKWY
Second Line	:	2ND FLOOR FINANCE DEPARTMENT
City	:	SECAUCUS
State	:	NJ
Zip	:	07094-2977
Country	:	US
Telephone Number	:	201-770-3709
Fax Number	:	201-770-3750

Provider Business Practice Location Address
First Line	:	1825 KENNEDY BOULEVARD
Second Line	:	ECECUTIVE OFFICE
City	:	JERSEY CITY
State	:	NJ
Zip	:	07305-2106
Country	:	US
Telephone Number	:	201-770-3709
Fax Number	:	201-770-3750

Authorized Official
Title or Position	:	CHIEF FINANCIAL OFFICER
Name	:	MR. PAUL GOLDBERG
Credential	:
Telephone Number	:	201-521-5920

Provider Enumeration Date	:	11/08/2006
Last Update Date	:	04/29/2011

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Directions to “GREENVILLE HOSPITAL ” Practice Location

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