Provider Demographics
NPI:1790059947
Name:HUMC OPCO, LLC
Entity Type:Organization
Organization Name:HUMC OPCO, LLC
Other - Org Name:HOBOKEN UNIVERSITY MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER OF MANAGECARE CREDENTIALING
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-821-8911
Mailing Address - Street 1:308 WILLOW AVE
Mailing Address - Street 2:
Mailing Address - City:HOBOKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07030-3808
Mailing Address - Country:US
Mailing Address - Phone:201-418-1000
Mailing Address - Fax:201-418-2040
Practice Address - Street 1:308 WILLOW AVE
Practice Address - Street 2:
Practice Address - City:HOBOKEN
Practice Address - State:NJ
Practice Address - Zip Code:07030-3808
Practice Address - Country:US
Practice Address - Phone:201-418-2184
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-06
Last Update Date:2018-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ10908314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ282N00000XOtherHOSPITAL - LONG TERM CARE