Provider Demographics
NPI:1831292259
Name:MUHLENBERG REGIONAL MEDICAL CENTER, INC
Entity Type:Organization
Organization Name:MUHLENBERG REGIONAL MEDICAL CENTER, INC
Other - Org Name:MUHLENBERG HOME CARE PROGRAM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:P
Authorized Official - Last Name:MCGEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-632-1501
Mailing Address - Street 1:1200 PARK AVE & RANDOLPH RD
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07060-3300
Mailing Address - Country:US
Mailing Address - Phone:732-632-1571
Mailing Address - Fax:732-632-1644
Practice Address - Street 1:1200 PARK AVE & RANDOLPH RD
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07060-3300
Practice Address - Country:US
Practice Address - Phone:732-632-1571
Practice Address - Fax:732-632-1644
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-07
Last Update Date:2010-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ72001251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0L0554OtherHEALTHNET
NJ50302OtherAMERIGROUP
NJ317059OtherAETNA
NJUN000013700OtherAMERICHOICE
NJ1091631OtherHORIZON MERCY OF NJ
NJ317059OtherNJ HORIZON BCBS
NJ3691004Medicaid
NJ38831OtherUNIVERSITY HEALTH PLAN
NJ38831OtherUNIVERSITY HEALTH PLAN
NJ317059OtherAETNA
NJ1091631OtherHORIZON MERCY OF NJ
NJUN000013700OtherAMERICHOICE
NJ=========OtherAMERIHEALTH
NJ=========OtherGENTIVA CIGNA
NJ50302OtherAMERIGROUP
NJ=========OtherCONSUMER HEALTHNET WORK
NJ=========OtherGENTIVA CIGNA