Provider Demographics
NPI:1437210838
Name:INTERIM HEALTHCARE MIDDLESEX-SOMERSET, INC.
Entity Type:Organization
Organization Name:INTERIM HEALTHCARE MIDDLESEX-SOMERSET, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:R
Authorized Official - Last Name:STANTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-756-1515
Mailing Address - Street 1:265 DURHAM AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH PLAINFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07080-2504
Mailing Address - Country:US
Mailing Address - Phone:908-756-1515
Mailing Address - Fax:908-756-5915
Practice Address - Street 1:265 DURHAM AVE
Practice Address - Street 2:
Practice Address - City:SOUTH PLAINFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07080-2504
Practice Address - Country:US
Practice Address - Phone:908-756-1515
Practice Address - Fax:908-756-5915
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-12
Last Update Date:2008-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJHP0015702251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0087301Medicaid