Provider Demographics
NPI:1275084840
Name:RED OAK HOSPICE LLC
Entity Type:Organization
Organization Name:RED OAK HOSPICE LLC
Other - Org Name:RED OAK HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:SAM
Authorized Official - Middle Name:
Authorized Official - Last Name:STERN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:877-567-0402
Mailing Address - Street 1:14C 53RD ST STE 224N
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11232-2644
Mailing Address - Country:US
Mailing Address - Phone:877-567-0402
Mailing Address - Fax:
Practice Address - Street 1:154 SUNNY SLOPE DR
Practice Address - Street 2:
Practice Address - City:BRIDGETON
Practice Address - State:NJ
Practice Address - Zip Code:08302-5732
Practice Address - Country:US
Practice Address - Phone:732-358-6883
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-19
Last Update Date:2021-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based