Provider Demographics
NPI:1083982490
Name:PASSAIC HEALTHCARE SERVICES, LLC
Entity Type:Organization
Organization Name:PASSAIC HEALTHCARE SERVICES, LLC
Other - Org Name:ALLCARE MEDICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:WINTHROP
Authorized Official - Middle Name:
Authorized Official - Last Name:HAYES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-244-4660
Mailing Address - Street 1:125 NEWTOWN RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:PLAINVIEW
Mailing Address - State:NY
Mailing Address - Zip Code:11803-4314
Mailing Address - Country:US
Mailing Address - Phone:800-244-4660
Mailing Address - Fax:866-511-0294
Practice Address - Street 1:41 COLUMBUS AVE
Practice Address - Street 2:
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10801-6922
Practice Address - Country:US
Practice Address - Phone:800-244-4660
Practice Address - Fax:866-511-0294
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-13
Last Update Date:2015-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies