Provider Demographics
NPI:1346648151
Name:SOUTH JERSEY HOME CARE
Entity Type:Organization
Organization Name:SOUTH JERSEY HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:
Authorized Official - Last Name:POPILOCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-399-7488
Mailing Address - Street 1:1028 ASBURY AVE
Mailing Address - Street 2:
Mailing Address - City:OCEAN CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:08226-3330
Mailing Address - Country:US
Mailing Address - Phone:609-399-4788
Mailing Address - Fax:609-525-0242
Practice Address - Street 1:1028 ASBURY AVE
Practice Address - Street 2:
Practice Address - City:OCEAN CITY
Practice Address - State:NJ
Practice Address - Zip Code:08226-3330
Practice Address - Country:US
Practice Address - Phone:609-399-4788
Practice Address - Fax:609-525-0242
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-10
Last Update Date:2014-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJHP0064500251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health