St Mark Home Care LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

HP0175700 Issued in NJ

Legal business name

ST MARK HOME CARE LLC

Practice address

895 Bergen Ave
307
Jersey City, NJ 07306-4309

Phone

(201) 424-4847

Fax

(201) 758-7778

NPI assigned

Jan 6, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Wafik Fakhouri, MR

Title

President

Phone

(201) 424-4847

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

St Mark Home Care2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• St. Mark Home Care

  • Home Health Agency
  • Jersey City, NJ
  • NPI 1457767964
  NPD tax ID

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1452038400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1452038400000",
    "number": "1073979167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "895 BERGEN AVE",
            "address_2": "307",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073064309",
            "telephone_number": "201-424-4847",
            "fax_number": "201-758-7778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "895 BERGEN AVE",
            "address_2": "307",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073064309",
            "telephone_number": "201-424-4847",
            "fax_number": "201-758-7778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST MARK HOME CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-06",
        "last_updated": "2016-01-06",
        "status": "A",
        "authorized_official_last_name": "FAKHOURI",
        "authorized_official_first_name": "WAFIK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "201-424-4847",
        "authorized_official_credential": "MR"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NJ",
            "license": "HP0175700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "HP017500",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sriniketh Srinivasa, DMD
• Sahana Sriram, LMHC LP
• SS Dental
• St Andrew Pharmacy LLC
• St Kerollos Pharmacy Inc.
• St Mary & St Moses Pharmacy
• St Mary Women Care
• St Matthew Physical Therapy and Wellness Center LLC
• St Vincent Hospital in Manhattan
• St. Ann'S Adult Medical Day Care

• Home Health Agency in Jersey City, NJ
• Providers in Jersey City, NJ by specialty
• Home Health Agency in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.