Provider Demographics
NPI:1669568895
Name:SHORE HEALTH CARE CENTER, INC.
Entity type:Organization
Organization Name:SHORE HEALTH CARE CENTER, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BENZION
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHACHTER
Authorized Official - Suffix:
Authorized Official - Credentials:LNHA
Authorized Official - Phone:732-905-0700
Mailing Address - Street 1:527 RIVER AVE
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-4722
Mailing Address - Country:US
Mailing Address - Phone:732-905-0700
Mailing Address - Fax:732-905-3382
Practice Address - Street 1:527 RIVER AVE
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-4722
Practice Address - Country:US
Practice Address - Phone:732-905-0700
Practice Address - Fax:732-905-3382
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-05
Last Update Date:2007-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ061536314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ5608104Medicaid
NJ315327Medicare PIN