Healthcare Provider Details

I. General information

NPI: 1003381237
Provider Name (Legal Business Name): SALEM HOME HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2018
Last Update Date: 08/21/2020
Certification Date: 08/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 WOODSTOWN ROAD 2ND FLOOR, 2 EAST
SALEM NJ
08079-2064
US

IV. Provider business mailing address

310 WOODSTOWN ROAD 2ND FLOOR, 2 EAST
SALEM NJ
08079
US

V. Phone/Fax

Practice location:
  • Phone: 856-935-1000
  • Fax: 856-935-3175
Mailing address:
  • Phone: 856-678-8500
  • Fax: 856-678-5180

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. WILLIAM J COLGAN
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 973-429-7900