MEDICARE: SENIORCARE OF HAMILTON 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
1	314000000X	Skilled Nursing Facility	061111	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	5212497	OTHER	NJ	AETNA (TRADITIONAL)
2	01000356300	OTHER	NJ	AMERICHOICE
3	315223	OTHER	NJ	HORIZON BC/BS (SKILLED)
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	2499838	OTHER	NJ	AETNA (HMO)
6	001018	OTHER	NJ	HORIZON BC/BS (SUBACUTE)
7	97307	OTHER	NJ	AMERICAID

General Provider Information

NPI Number	:	1952397309
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SENIORCARE OF HAMILTON LLC

Provider Business Mailing Address
First Line	:	1059 EDINBURG RD
Second Line	:
City	:	HAMILTON SQUARE
State	:	NJ
Zip	:	08690-1229
Country	:	US
Telephone Number	:	609-588-0091
Fax Number	:

Provider Business Practice Location Address
First Line	:	1059 EDINBURG RD
Second Line	:
City	:	HAMILTON SQUARE
State	:	NJ
Zip	:	08690-1229
Country	:	US
Telephone Number	:	609-588-0091
Fax Number	:

Authorized Official
Title or Position	:	LNHA
Name	:	JOSEF BOGDAN
Credential	:
Telephone Number	:	609-588-0091

Provider Enumeration Date	:	09/21/2005
Last Update Date	:	06/30/2010

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Directions to “SENIORCARE OF HAMILTON LLC ” Practice Location

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