Provider Demographics
NPI:1124011762
Name:HEART-CARE CORPORATION OF AMERICA
Entity Type:Organization
Organization Name:HEART-CARE CORPORATION OF AMERICA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:CODY
Authorized Official - Middle Name:
Authorized Official - Last Name:COWPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-720-0502
Mailing Address - Street 1:275 PHILLIPS BLVD
Mailing Address - Street 2:
Mailing Address - City:EWING
Mailing Address - State:NJ
Mailing Address - Zip Code:08618
Mailing Address - Country:US
Mailing Address - Phone:800-222-2842
Mailing Address - Fax:800-840-6937
Practice Address - Street 1:275 PHILLIPS BLVD
Practice Address - Street 2:
Practice Address - City:EWING
Practice Address - State:NJ
Practice Address - Zip Code:08618
Practice Address - Country:US
Practice Address - Phone:800-222-2842
Practice Address - Fax:800-840-6937
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-30
Last Update Date:2020-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6240704Medicaid
NJ6240704Medicaid