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General NPI Number Information
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NPI Number | 1598255002
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Entity Type | Organization
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Legal Business Name | CHAMPION HEALTH SH LLC
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Dates
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Enumeration Date | 05/10/2018
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Last Update Date | 08/01/2024
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Provider Practice Location Address
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Address Line | 189 US HIGHWAY 46
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City | SADDLE BROOK
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State | NJ
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Zip | 07663-6215
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Country | US
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Telephone | 201-642-4200
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 10940
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City | FAIRFIELD
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State | NJ
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Zip | 07004-6940
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWN
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Name | CHAMPION HW
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Credential |
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Telephone | 201-642-4200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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