Provider Demographics
NPI:1477647337
Name:PROMPTCARE HOME INFUSION, LLC
Entity Type:Organization
Organization Name:PROMPTCARE HOME INFUSION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:JARDINA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-692-2747
Mailing Address - Street 1:41 SPRING ST STE 103B
Mailing Address - Street 2:
Mailing Address - City:NEW PROVIDENCE
Mailing Address - State:NJ
Mailing Address - Zip Code:07974-1143
Mailing Address - Country:US
Mailing Address - Phone:866-526-1297
Mailing Address - Fax:855-454-4553
Practice Address - Street 1:41 SPRING ST STE 103B
Practice Address - Street 2:
Practice Address - City:NEW PROVIDENCE
Practice Address - State:NJ
Practice Address - Zip Code:07974-1143
Practice Address - Country:US
Practice Address - Phone:866-526-1297
Practice Address - Fax:855-454-4553
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RS00545700332BP3500X, 3336C0004X, 3336H0001X, 3336S0011X
3336C0003X, 3336M0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336M0002XSuppliersPharmacyMail Order Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02859763Medicaid
NJ0577472Medicaid
NJ0123994Medicaid
NY02859763Medicaid