Provider Demographics
NPI:1528125739
Name:INTERIM HEALTHCARE MANAGED SERVICES
Entity type:Organization
Organization Name:INTERIM HEALTHCARE MANAGED SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT OF OPERATIONS
Authorized Official - Prefix:MRS
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:BARTORELLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-393-4545
Mailing Address - Street 1:113 WHITE HORSE RD W STE 9
Mailing Address - Street 2:
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-3671
Mailing Address - Country:US
Mailing Address - Phone:856-783-0312
Mailing Address - Fax:856-783-8049
Practice Address - Street 1:113 WHITE HORSE RD W STE 9
Practice Address - Street 2:
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-3671
Practice Address - Country:US
Practice Address - Phone:856-783-0312
Practice Address - Fax:856-783-8049
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-03
Last Update Date:2008-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJHP0016211251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0089630Medicaid