Provider Demographics
NPI:1235541251
Name:MOM & POP CARE INC
Entity Type:Organization
Organization Name:MOM & POP CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:KAY
Authorized Official - Middle Name:
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-391-4837
Mailing Address - Street 1:230 E. RIDGEWOOD AVENUE
Mailing Address - Street 2:BUILDING 3, FLOOR 1
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652
Mailing Address - Country:US
Mailing Address - Phone:844-488-1234
Mailing Address - Fax:973-255-2247
Practice Address - Street 1:111 MALTESE DR
Practice Address - Street 2:SECOND FLOOR
Practice Address - City:TOTOWA
Practice Address - State:NJ
Practice Address - Zip Code:07512-1402
Practice Address - Country:US
Practice Address - Phone:914-391-4837
Practice Address - Fax:732-283-4020
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-25
Last Update Date:2016-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1006603416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport