Hackensack Meridian Ambulatory Care, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

HACKENSACK MERIDIAN AMBULATORY CARE, INC.

Practice address

50 Polifly Rd
Hackensack, NJ 07601-3287

Phone

(201) 646-1166

Fax

(201) 487-3835

NPI assigned

Oct 30, 2018

Organization subpart

No

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

Authorized official

Name

Mr. Richard Hand

Title

Senior Finance Administration

Phone

(732) 481-8529

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Hackensack Meridian Health Nursing & Rehab Doing business as

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

{
    "created_epoch": "1540857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1640563200000",
    "number": "1659848489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3349 HWY 138",
            "address_2": "BUILDING C SUITE A",
            "city": "WALL TOWNSHIP",
            "state": "NJ",
            "postal_code": "077199671",
            "telephone_number": "732-751-3624",
            "fax_number": "732-751-3649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 POLIFLY RD",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076013287",
            "telephone_number": "201-646-1166",
            "fax_number": "201-487-3835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HACKENSACK MERIDIAN AMBULATORY CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-30",
        "last_updated": "2021-12-27",
        "certification_date": "2021-12-27",
        "status": "A",
        "authorized_official_last_name": "HAND",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "SENIOR FINANCE ADMINISTRATION",
        "authorized_official_telephone_number": "732-481-8529",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "315295",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hackensack Meridian Health Nursing & Rehab",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Hackensack Meridian Health Nursing & Rehab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Hackensack, NJ
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 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.