Provider Demographics
NPI:1396790796
Name:ROEPHEL CONVALESCENT CENTER, LLC
Entity type:Organization
Organization Name:ROEPHEL CONVALESCENT CENTER, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CORPORATE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JANE
Authorized Official - Middle Name:
Authorized Official - Last Name:DROPESKEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-925-4231
Mailing Address - Street 1:101 E STATE ST
Mailing Address - Street 2:
Mailing Address - City:KENNETT SQUARE
Mailing Address - State:PA
Mailing Address - Zip Code:19348-3109
Mailing Address - Country:US
Mailing Address - Phone:610-925-4436
Mailing Address - Fax:610-925-4351
Practice Address - Street 1:1700 WYNWOOD DR
Practice Address - Street 2:
Practice Address - City:CINNAMINSON
Practice Address - State:NJ
Practice Address - Zip Code:08077-2440
Practice Address - Country:US
Practice Address - Phone:856-829-9000
Practice Address - Fax:856-829-3305
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-23
Last Update Date:2018-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ060314314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
0005676000OtherAMERIHEALTH-TRADITIONAL
0005676000OtherIBC-MANAGED CARE
77OtherELDER HEALTH
0005676000OtherAMERIHEALTH-MANAGED CARE
NJ03010Medicaid
210114OtherUS FAMILY HEALTH PLAN
315047OtherHORIZION - SNF
14401OtherAETNA-HMO
23-3476781OtherLOCAL 825
0005676000OtherIBC-TRADITIONAL
000824OtherHORIZION - SUB
IY0170OtherHEALTHNET OF PA
NJ4465709OtherUNISYS
0005676000OtherIBC-MANAGED CARE
315047OtherHORIZION - SNF
=========OtherHCPC
14401OtherAETNA-HMO
23-3476781OtherLOCAL 825
NJ03010Medicaid