Provider Demographics
NPI:1083778336
Name:RTA PEDIATRIC CARE INC
Entity Type:Organization
Organization Name:RTA PEDIATRIC CARE INC
Other - Org Name:FAMILY MEDICAL EQUIPMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:BART
Authorized Official - Middle Name:H
Authorized Official - Last Name:PRICE
Authorized Official - Suffix:
Authorized Official - Credentials:RRT
Authorized Official - Phone:856-794-8050
Mailing Address - Street 1:106 W LANDIS AVE UNIT 10
Mailing Address - Street 2:
Mailing Address - City:VINELAND
Mailing Address - State:NJ
Mailing Address - Zip Code:08360-8114
Mailing Address - Country:US
Mailing Address - Phone:856-794-8050
Mailing Address - Fax:856-794-8051
Practice Address - Street 1:882 S DELSEA DR
Practice Address - Street 2:
Practice Address - City:VINELAND
Practice Address - State:NJ
Practice Address - Zip Code:08360-4464
Practice Address - Country:US
Practice Address - Phone:856-697-8002
Practice Address - Fax:856-697-8003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-21
Last Update Date:2023-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJC0000038207332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0028461Medicaid
DE1083778336OtherCOVENTRY DE
NJ60036465OtherHORIZON NEW JERSEY HEALTH
NJ7035450OtherAETNA NJ
PA0000293000OtherIBC (KHPE, AMERI, PC,)
PA001886923OtherHIGHMARK BC OF PA
PA10229233280001Medicaid
DE1083778336Medicaid
NJ233089689OtherUNITED HEALTH CARE
PA264419OtherUNISON PA
DE40264419OtherUNISON DE
NJ0000293000OtherAMERIHEALTH ADMINISTRATOR
PA30047814OtherKEYSTONE FIRST
PA59637OtherCOVENTRY HEALTHCARE PA
NJ60036465OtherHORIZON NEW JERSEY HEALTH
DE40264419OtherUNISON DE