Promedica Senior Care of Moorestown NJ, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

PROMEDICA SENIOR CARE OF MOORESTOWN NJ, LLC

Doing business as

ProMedica Skilled Nursing and Rehabilitation (Moorestown)

Practice address

212 Marter Ave
Moorestown, NJ 08057-3114

Phone

(419) 252-5500

NPI assigned

May 5, 2021

Last updated

May 5, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Martin David Allen

Title

Director

Phone

(419) 252-5734

Specialties & licenses 1

Addresses

Other names 1

• ProMedica Skilled Nursing and Rehabilitation (Moorestown) Doing business as

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

{
    "created_epoch": "1620172800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620172800000",
    "number": "1447833546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 N SUMMIT ST",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436041531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 MARTER AVE",
            "city": "MOORESTOWN",
            "state": "NJ",
            "postal_code": "080573114",
            "telephone_number": "419-252-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROMEDICA SENIOR CARE OF MOORESTOWN NJ, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-05",
        "last_updated": "2021-05-05",
        "certification_date": "2021-05-05",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "419-252-5734"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ProMedica Skilled Nursing and Rehabilitation (Moorestown)",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Cheryl C. Pride I, MSW, LCSW
• Primary Care of Moorestown PC
• Princeton Medical Center (Princeton House)
• Private Duty Services of Partners in Home Care Inc.
• Progressive Care Medical Group of NJ, LLC
• Jennifer Pugliese, LCSW
• Sergio H. Pulido, DO
• Wyndham Pursley, CRNP
• Daniel P Putnam, M.D.
• Christen Pyle

• Skilled Nursing Facility in Moorestown, NJ
• Providers in Moorestown, NJ by specialty
• Skilled Nursing Facility in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2021; 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.