Healthcare Provider Details

I. General information

NPI: 1073874590
Provider Name (Legal Business Name): OWIN EXPRESS HOME HEALTH AGENCY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/31/2012
Last Update Date: 05/31/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

276 WILDFLOWER LN
HILLSBOROUGH NJ
08844-4873
US

IV. Provider business mailing address

276, WILDFLOWER LANE
HILLSBOROUGH NJ
08844
US

V. Phone/Fax

Practice location:
  • Phone: 973-333-8402
  • Fax: 973-653-3539
Mailing address:
  • Phone: 973-333-8402
  • Fax: 973-653-3539

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHP0147500
License Number StateNJ

VIII. Authorized Official

Name: MR. UHUNOMA SUNNY EWERE
Title or Position: PRESIDENT
Credential: MPA
Phone: 908-265-0164