Provider Demographics
NPI:1164735882
Name:SHS NUTRITION, LLC
Entity Type:Organization
Organization Name:SHS NUTRITION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SARA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAMA
Authorized Official - Suffix:
Authorized Official - Credentials:RD
Authorized Official - Phone:732-395-1282
Mailing Address - Street 1:15 EDWARD AVE
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NJ
Mailing Address - Zip Code:08831-8524
Mailing Address - Country:US
Mailing Address - Phone:732-395-1282
Mailing Address - Fax:
Practice Address - Street 1:24 STELTON RD
Practice Address - Street 2:
Practice Address - City:PISCATAWAY
Practice Address - State:NJ
Practice Address - Zip Code:08854-2639
Practice Address - Country:US
Practice Address - Phone:732-395-1282
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-22
Last Update Date:2013-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ00954704133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty