Healthcare Provider Details
I. General information
NPI: 1225547862
Provider Name (Legal Business Name): COXPHIT LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/27/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
809 22ND STREET UNIT 506
UNION CITY NJ
07087
US
IV. Provider business mailing address
809 22ND ST APT 506
UNION CITY NJ
07087-9139
US
V. Phone/Fax
- Phone: 201-655-9105
- Fax:
- Phone: 201-655-9105
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 385HR2060X |
| Taxonomy | Child Intellectual and/or Developmental Disabilities Respite Care |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 385HR2065X |
| Taxonomy | Child Physical Disabilities Respite Care |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JONATHAN
B
COX
Title or Position: OWNER
Credential: MBA
Phone: 201-655-9105