Provider Demographics
NPI:1699738732
Name:BUCKINGHAM SNF LLC
Entity type:Organization
Organization Name:BUCKINGHAM SNF LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:
Authorized Official - First Name:YOSSI
Authorized Official - Middle Name:
Authorized Official - Last Name:ZUCKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:866-942-1344
Mailing Address - Street 1:4597 ROUTE 9 N
Mailing Address - Street 2:
Mailing Address - City:HOWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07731-3382
Mailing Address - Country:US
Mailing Address - Phone:866-942-1344
Mailing Address - Fax:732-942-1312
Practice Address - Street 1:820 DURHAM RD
Practice Address - Street 2:
Practice Address - City:BUCKINGHAM
Practice Address - State:PA
Practice Address - Zip Code:18912
Practice Address - Country:US
Practice Address - Phone:215-598-7181
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA023502314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0011293300001Medicaid
01129330001OtherAMERICHOICE
1027492OtherKEYSTONE MERCY HEALTHPLAN
0005751000OtherBLUE CROSS
0005751000OtherKEYSTONE 65
51983OtherAETNA US HEALTHCARE
30932OtherHEALTH PARTNERS
51983OtherAETNA US HEALTHCARE