Provider Demographics
NPI:1013339613
Name:SSALEM HOME CARE SERVICES
Entity Type:Organization
Organization Name:SSALEM HOME CARE SERVICES
Other - Org Name:MEMORIAL HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:REGIONAL BILLING SPECIALISTS
Authorized Official - Prefix:MRS
Authorized Official - First Name:DANA
Authorized Official - Middle Name:
Authorized Official - Last Name:TRIMBUR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-327-7768
Mailing Address - Street 1:13 ARMAND HAMMER BLVD
Mailing Address - Street 2:
Mailing Address - City:POTTSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19464-5067
Mailing Address - Country:US
Mailing Address - Phone:610-327-7768
Mailing Address - Fax:
Practice Address - Street 1:13 ARMAND HAMMER BLVD
Practice Address - Street 2:
Practice Address - City:POTTSTOWN
Practice Address - State:PA
Practice Address - Zip Code:19464-5067
Practice Address - Country:US
Practice Address - Phone:610-327-7768
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-16
Last Update Date:2014-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0218863Medicaid