Provider Demographics
NPI:1235118944
Name:SALEM HOME CARE SERVICES LLC
Entity Type:Organization
Organization Name:SALEM HOME CARE SERVICES LLC
Other - Org Name:MEMORIAL HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR BUSINESS OFFICE SUPPORT
Authorized Official - Prefix:MS
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLTSFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-465-7466
Mailing Address - Street 1:310 SALEM WOODSTOWN RD
Mailing Address - Street 2:2ND FLOOR, 2 EAST
Mailing Address - City:SALEM
Mailing Address - State:NJ
Mailing Address - Zip Code:08079-2064
Mailing Address - Country:US
Mailing Address - Phone:856-678-8500
Mailing Address - Fax:856-678-5180
Practice Address - Street 1:310 SALEM WOODSTOWN RD
Practice Address - Street 2:2ND FLOOR, 2 EAST
Practice Address - City:SALEM
Practice Address - State:NJ
Practice Address - Zip Code:08079-2064
Practice Address - Country:US
Practice Address - Phone:856-678-8500
Practice Address - Fax:856-678-5180
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-11
Last Update Date:2015-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ11702251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0009913000OtherAMERIHEALTH
NJ1084086OtherNJ HEALTH
NJ5855482OtherAETNA NON-HMO
NJ9036008Medicaid
NJ3067511OtherAETNA
NJ9035702OtherCCPED
NJ347720201OtherUS DEPT OF LABOR
NJSA000000802OtherAMERICHOICE
NJ2K2051OtherACS HEALTH NET
NJ3067511OtherAETNA