Provider Demographics
NPI:1124503636
Name:GENERAL CONFERENCE OF SEVENTH DAY ADVENTIST HACKETTSTOWN COMMUNITY HOS
Entity type:Organization
Organization Name:GENERAL CONFERENCE OF SEVENTH DAY ADVENTIST HACKETTSTOWN COMMUNITY HOS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SVP ADM. & FINANCE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:LENAHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-829-4240
Mailing Address - Street 1:475 SOUTH ST
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960-6459
Mailing Address - Country:US
Mailing Address - Phone:973-829-4240
Mailing Address - Fax:
Practice Address - Street 1:651 WILLOW GROVE ST
Practice Address - Street 2:
Practice Address - City:HACKETTSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07840-1799
Practice Address - Country:US
Practice Address - Phone:908-850-6900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-01
Last Update Date:2018-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ4141300Medicaid