Basic Information
| Provider Information | |||||||||
| NPI: | 1922095116 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HUNTERDON MEDICAL CENTER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2100 WESCOTT DR | ||||||||
| Address2: | |||||||||
| City: | FLEMINGTON | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 088224603 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9087886100 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2100 WESCOTT DR | ||||||||
| Address2: | |||||||||
| City: | FLEMINGTON | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 088224603 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9087886100 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/03/2005 | ||||||||
| LastUpdateDate: | 11/19/2021 | ||||||||
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| AuthorizedOfficialLastName: | WHITE | ||||||||
| AuthorizedOfficialFirstName: | HERBERT | ||||||||
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| AuthorizedOfficialTitleorPosition: | CHIEF FINANCIAL OFFICER | ||||||||
| AuthorizedOfficialTelephone: | 9087886153 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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| NPICertificationDate: | 11/19/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | N | Hospitals | General Acute Care Hospital | 282N00000X | 11001 | NJ | Y | Hospitals | General Acute Care Hospital |
ID Information
| ID | Type | State | Issuer | Description | 4135202 | 05 | NJ | MEDICAID | HO4402 | 01 | NJ | OXFORD | OTHER | 16247 | 01 | NJ | AMERIGROUP | OTHER | 1015880 | 01 | NJ | HORIZON MERCY | OTHER | 4530 | 01 | NJ | AMERIHEALTH | OTHER | 310005 | 01 | NJ | HORIZON BCBS | OTHER | 0013013 | 01 | NJ | AETNA | OTHER | IL5008 | 01 | NJ | HEALTHNET | OTHER |