Provider Demographics
NPI: | 1689614927 |
---|---|
Name: | HBA MANAGEMENT, INC. |
Entity type: | Organization |
Organization Name: | HBA MANAGEMENT, INC. |
Other - Org Name: | <UNAVAIL> |
Other - Org Type: | |
Authorized Official - Title/Position: | COO |
Authorized Official - Prefix: | MR |
Authorized Official - First Name: | MICHAEL |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | ROSIAK |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 856-489-4520 |
Mailing Address - Street 1: | 92 BRICK RD |
Mailing Address - Street 2: | |
Mailing Address - City: | MARLTON |
Mailing Address - State: | NJ |
Mailing Address - Zip Code: | 08053-2177 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 856-489-4520 |
Mailing Address - Fax: | 856-489-4541 |
Practice Address - Street 1: | 92 BRICK ROAD |
Practice Address - Street 2: | |
Practice Address - City: | MARLTON |
Practice Address - State: | NJ |
Practice Address - Zip Code: | 08053 |
Practice Address - Country: | US |
Practice Address - Phone: | 856-489-4520 |
Practice Address - Fax: | 856-489-4541 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2006-06-07 |
Last Update Date: | 2016-03-30 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 283XC2000X | Hospitals | Rehabilitation Hospital | Children |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
NJ | 7584407 | Medicaid | |
PA | 0018422500001 | Medicaid | |
313302 | Medicare PIN |