Provider Demographics
NPI:1588809248
Name:ROBERT WOOD JOHNSON VISITING NURSES, INC.
Entity Type:Organization
Organization Name:ROBERT WOOD JOHNSON VISITING NURSES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:GAYLORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-224-6968
Mailing Address - Street 1:23 MAIN ST STE D1
Mailing Address - Street 2:
Mailing Address - City:HOLMDEL
Mailing Address - State:NJ
Mailing Address - Zip Code:07733-2136
Mailing Address - Country:US
Mailing Address - Phone:732-224-6914
Mailing Address - Fax:732-784-9710
Practice Address - Street 1:972 SHOPPES BLVD
Practice Address - Street 2:
Practice Address - City:NORTH BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08902-2776
Practice Address - Country:US
Practice Address - Phone:732-743-4643
Practice Address - Fax:732-743-4659
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-10
Last Update Date:2018-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X
NJ22235251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ22235OtherHOME CARE LICENSE
NJ225282Medicaid
NJ22235OtherHOME CARE LICENSE