Provider Demographics
NPI:1710137104
Name:COUNTY OF UNION
Entity Type:Organization
Organization Name:COUNTY OF UNION
Other - Org Name:RUNNELLS SPECIALIZED HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR - HOSPITAL FINANCE
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:T
Authorized Official - Last Name:DRUMMOND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-771-5705
Mailing Address - Street 1:40 WATCHUNG WAY
Mailing Address - Street 2:FINANCE DEPT.
Mailing Address - City:BERKELEY HEIGHTS
Mailing Address - State:NJ
Mailing Address - Zip Code:07922-2600
Mailing Address - Country:US
Mailing Address - Phone:908-771-5705
Mailing Address - Fax:908-771-0376
Practice Address - Street 1:40 WATCHUNG WAY
Practice Address - Street 2:
Practice Address - City:BERKELEY HEIGHTS
Practice Address - State:NJ
Practice Address - Zip Code:07922-2600
Practice Address - Country:US
Practice Address - Phone:908-771-5705
Practice Address - Fax:908-771-0376
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COUNTY OF UNION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-09-23
Last Update Date:2013-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22001L314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ4505514Medicaid
NJ4505506Medicaid
NJ4505514Medicaid