Provider Demographics
NPI:1184900326
Name:REGAL HOME CARE CORPORATION
Entity type:Organization
Organization Name:REGAL HOME CARE CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SIMON
Authorized Official - Middle Name:
Authorized Official - Last Name:GRUENZWEIG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-860-5026
Mailing Address - Street 1:96 E 9TH ST
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-2890
Mailing Address - Country:US
Mailing Address - Phone:917-860-5026
Mailing Address - Fax:
Practice Address - Street 1:96 E 9TH ST
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-2890
Practice Address - Country:US
Practice Address - Phone:917-860-5026
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-02
Last Update Date:2011-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health