Provider Demographics
NPI:1245297563
Name:PERSANTE CONTINUING CARE INC
Entity type:Organization
Organization Name:PERSANTE CONTINUING CARE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE-PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:MURRAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-793-1557
Mailing Address - Street 1:130 GAITHER DR
Mailing Address - Street 2:STE 136
Mailing Address - City:MT LAUREL
Mailing Address - State:NJ
Mailing Address - Zip Code:08054-1715
Mailing Address - Country:US
Mailing Address - Phone:856-793-1557
Mailing Address - Fax:888-227-9009
Practice Address - Street 1:130 GAITHER DR
Practice Address - Street 2:STE 136
Practice Address - City:MT LAUREL
Practice Address - State:NJ
Practice Address - Zip Code:08054-1715
Practice Address - Country:US
Practice Address - Phone:856-793-1557
Practice Address - Fax:888-227-9009
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PERSANTE HEALTH CARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-04-28
Last Update Date:2014-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2477602Medicaid
4741080001Medicare NSC