Provider Demographics
NPI:1861486870
Name:ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL AT RAHWAY
Entity Type:Organization
Organization Name:ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL AT RAHWAY
Other - Org Name:RAHWAY HOSPITAL
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:KIRK
Authorized Official - Middle Name:
Authorized Official - Last Name:TICE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-499-6050
Mailing Address - Street 1:865 STONE ST
Mailing Address - Street 2:
Mailing Address - City:RAHWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:07065-2742
Mailing Address - Country:US
Mailing Address - Phone:732-499-6084
Mailing Address - Fax:732-499-6106
Practice Address - Street 1:865 STONE ST
Practice Address - Street 2:
Practice Address - City:RAHWAY
Practice Address - State:NJ
Practice Address - Zip Code:07065-2742
Practice Address - Country:US
Practice Address - Phone:732-499-6084
Practice Address - Fax:732-499-6106
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RWJ BARNABAS HEALTH INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-09-06
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ12006282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJHO4953OtherOXFORD HEALTH PLAN
NJ1008954OtherHORIZON NJ HEALTH
NJIL5193OtherHEALTHNET
NJ001570OtherNYBC/WELLCHOICE
NJ004737OtherKEYSTONE
NJ0009811OtherAETNA PROVIDER NUMBER
NJ001570OtherWELLCHOICE
NJ310224OtherHORIZON STATE HEALTH BENE
NJ3674401Medicaid
NJ310024OtherHORIZON NJBC
NJ50040OtherAMERIGROUP HOSP. #
NJHO4953OtherOXFORD HEALTH PLAN
NJ3674401Medicaid
NJ310024OtherHORIZON NJBC
NJ50040OtherAMERIGROUP HOSP. #