Provider Demographics
NPI:1114547502
Name:ST MARY HOME CARE INC
Entity type:Organization
Organization Name:ST MARY HOME CARE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:HANI
Authorized Official - Middle Name:
Authorized Official - Last Name:GERGIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-640-5954
Mailing Address - Street 1:141 SUTTON PL
Mailing Address - Street 2:
Mailing Address - City:NEW MILFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07646-1205
Mailing Address - Country:US
Mailing Address - Phone:201-679-6153
Mailing Address - Fax:
Practice Address - Street 1:141 SUTTON PL
Practice Address - Street 2:
Practice Address - City:NEW MILFORD
Practice Address - State:NJ
Practice Address - Zip Code:07646-1205
Practice Address - Country:US
Practice Address - Phone:201-679-6153
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-26
Last Update Date:2021-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)