Basic Information
| Provider Information | |||||||||
| NPI: | 1205176062 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | PASCACK VALLEY HOSPITAL LLC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | HACKENSACKUMC AT PASCACK VALLEY | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 250 OLD HOOK RD | ||||||||
| Address2: | |||||||||
| City: | WESTWOOD | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 076753123 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2018802700 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 250 OLD HOOK RD | ||||||||
| Address2: | |||||||||
| City: | WESTWOOD | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 076753123 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2018802700 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/15/2013 | ||||||||
| LastUpdateDate: | 05/20/2015 | ||||||||
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| AuthorizedOfficialLastName: | HOLLIMAN | ||||||||
| AuthorizedOfficialFirstName: | EMILY | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 2018802700 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | NJ | Y | Hospitals | General Acute Care Hospital |
No ID Information.