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General NPI Number Information
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NPI Number | 1326432022
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Entity Type | Organization
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Legal Business Name | PAXXON HEALTHCARE SERVICES LLC
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Dates
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Enumeration Date | 03/20/2015
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Last Update Date | 03/20/2015
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Provider Practice Location Address
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Address Line | 60 OCEAN AVE
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City | MANASQUAN
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State | NJ
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Zip | 08736-3220
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Country | US
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Telephone | 908-309-6642
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Fax |
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Provider Business Mailing Address
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Address Line | 60 OCEAN AVE
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City | MANASQUAN
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State | NJ
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Zip | 08736-3220
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Country | US
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Telephone | 908-309-6642
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Fax | 732-722-8082
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Authorized Official
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Title or Position | SUPERVISOR
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Name | WINSOME O KING
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Credential | OT
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Telephone | 610-991-2034
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 40-QA00471300
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License Number State | NJ
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