Provider Demographics
NPI:1811978141
Name:ALLCARE MEDICAL SNJ, LLC
Entity type:Organization
Organization Name:ALLCARE MEDICAL SNJ, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WINTHROP
Authorized Official - Middle Name:
Authorized Official - Last Name:HAYES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-244-4660
Mailing Address - Street 1:89 S COMMERCE WAY
Mailing Address - Street 2:SUITE 940
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18017-8952
Mailing Address - Country:US
Mailing Address - Phone:855-856-4433
Mailing Address - Fax:855-856-4477
Practice Address - Street 1:89 S COMMERCE WAY
Practice Address - Street 2:SUITE 940
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18017-8952
Practice Address - Country:US
Practice Address - Phone:855-856-4433
Practice Address - Fax:855-856-4477
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PASSAIC HEALTHCARE SERVICES LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-11-14
Last Update Date:2015-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No335E00000XSuppliersProsthetic/Orthotic Supplier
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ235920OtherAMERIGROUP
NJ81747OtherNORTHWOOD
NJ0001138000OtherKEYSTONE HEALTH PLANS
NJ0016829Medicaid
NJMI0000352-02OtherAMERICHOICE
NJ0001138000OtherAMERIHEALTH
NJ0001138000OtherINDEPENDENCE BLUE CROSS
NJ0001138000OtherPERSONAL CHOICE
PA1009356340003Medicaid
NJ41745OtherUNIVERSITY HEALTHPLANS
NJ0016829Medicaid