Innout Urology Home LLC

Organization Active NPI Skilled Nursing Facility · Stafford TWP, NJ

NPI 1982495412 · NPPES record last updated May 23, 2025

Key facts

NPI
1982495412
Entity type
Organization (NPI type 2)
Primary specialty
Skilled Nursing Facility 314000000X
Legal business name
INNOUT UROLOGY HOME LLC
Practice address
601 Washington Ave Ste J1002
Stafford TWP, NJ 08050-2801
Phone
(888) 433-9360
Fax
(609) 355-4777
NPI assigned
May 14, 2025
Organization subpart
No

Authorized official

Name
Leo Ligon, APN
Title
President
Phone
(888) 433-9360

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NJ

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20250911001310 NJ Part B Supplier - Clinic/Group Practice 0345743837 Receives reassigned benefits from 1 practitioner
Practice locations: Stafford TWP, NJ

National Provider Directory

Locations

601 Washington Ave
Ste J1002
Stafford Twp, NJ 08050
Phone (888) 433-9360

601 Washington Ave
#J1002
Stafford Twp, NJ 08050
Phone (888) 433-9360

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Yes
Family Nurse Practitioner
Group: 193200000X MULTI-SPECIALTY GROUP
363LF0000X

Addresses

Primary practice location

601 Washington Ave Ste J1002
Stafford TWP, NJ 08050-2801

Mailing address

601 Washington Ave Ste J1002
Stafford TWP, NJ 08050-2801
Phone (888) 433-9360

Other providers in Stafford TWP, NJ

All providers in Stafford TWP, NJ · Skilled Nursing Facility in New Jersey

Sources for this page

Verify at the official NPI Registry.