Provider Demographics
NPI:1881238673
Name:HACKENSACK MERIDIAN AMBULATORY CARE, INC.
Entity type:Organization
Organization Name:HACKENSACK MERIDIAN AMBULATORY CARE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SENIOR FINANCE ADMINISTRATION
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:HAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-481-8529
Mailing Address - Street 1:34 INDUSTRIAL WAY E
Mailing Address - Street 2:
Mailing Address - City:EATONTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07724-3319
Mailing Address - Country:US
Mailing Address - Phone:732-751-3655
Mailing Address - Fax:848-245-8199
Practice Address - Street 1:34 INDUSTRIAL WAY E
Practice Address - Street 2:
Practice Address - City:EATONTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07724-3319
Practice Address - Country:US
Practice Address - Phone:732-751-3655
Practice Address - Fax:848-245-8199
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HMH RESIDENTIAL CARE, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-11-05
Last Update Date:2024-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ28RS00774900OtherLICENSE