Tri State Domestic

LBN: Agc Services
Tri State Domestic is an health care organization with primary practice located at 336 President St , Saddle Brook NJ 07663-6323. The organization recently has 4 registered licenses in different health care specialties including Agencies / Home Health, Agencies / Hospice Care, Community Based, Agencies / Nursing Care, Agencies / Program of All-Inclusive Care for the Elderly (PACE) Provider Organization. Agencies / Home Health is the primary health care specialty. Agc Services can be contacted via phone (193) 928-3428, or through Mcgowan, Robert via phone (973) 928-3428.

Contact Information

Primary practice address
336 President St Saddle Brook NJ 07663-6323
Phone: (193) 928-3428
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Mcgowan, Robert
Phone: (973) 928-3428

Health care specialties

SpecialtyCodeLicense #State
Agencies / Home Health 251E00000X 35SI00033100 New Jersey
Agencies / Hospice Care, Community Based 251G00000X 35SI00033100 New Jersey
Agencies / Nursing Care 251J00000X 35SI00033100 New Jersey
Agencies / Program of All-Inclusive Care for the Elderly (PACE) Provider Organization 251T00000X 35SI00033100 New Jersey

Profile Details

NPI number 1619190428
LBN Legal business name Agc Services
DBA Doing business as Tri State Domestic
Authorized official Mcgowan, Robert
Entity Organization
Organization subpart 1 No
Enumeration date Apr 10th, 2007
Last updated Aug 22nd, 2020 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1619190428 NPPES
New Jersey MEDICAID 474 8107

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