Provider Demographics
NPI:1063538189
Name:HUNTLEIGH HEALTHCARE LLC
Entity type:Organization
Organization Name:HUNTLEIGH HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES.
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:S
Authorized Official - Last Name:ANGEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-223-1218
Mailing Address - Street 1:40 CHRISTOPHER WAY
Mailing Address - Street 2:
Mailing Address - City:EATONTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07724-3327
Mailing Address - Country:US
Mailing Address - Phone:800-223-1218
Mailing Address - Fax:732-676-1096
Practice Address - Street 1:49684 MARTIN DR
Practice Address - Street 2:
Practice Address - City:WIXOM
Practice Address - State:MI
Practice Address - Zip Code:48393-2400
Practice Address - Country:US
Practice Address - Phone:248-669-0142
Practice Address - Fax:248-669-0143
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4561520Medicaid
MI4561520Medicaid