Provider Demographics
NPI:1346261336
Name:COMPLETE CARE MEDICAL & REHAB PC
Entity Type:Organization
Organization Name:COMPLETE CARE MEDICAL & REHAB PC
Other - Org Name:COMPLETE CARE CHIROPRACTIC & REHAB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:J
Authorized Official - Last Name:SCHEETS
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:609-654-7020
Mailing Address - Street 1:639 STOKES RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:MEDFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:08055-3003
Mailing Address - Country:US
Mailing Address - Phone:609-654-7020
Mailing Address - Fax:609-654-7140
Practice Address - Street 1:639 STOKES RD
Practice Address - Street 2:SUITE 103
Practice Address - City:MEDFORD
Practice Address - State:NJ
Practice Address - Zip Code:08055-3003
Practice Address - Country:US
Practice Address - Phone:609-654-7020
Practice Address - Fax:609-654-7140
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-22
Last Update Date:2013-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMC05549111N00000X
NJ2251C2600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No2251C2600XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistCardiopulmonaryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ9034200Medicaid
NJ9034200Medicaid