Provider Demographics
NPI:1588220552
Name:HEALTHWORKSPRO LLC
Entity Type:Organization
Organization Name:HEALTHWORKSPRO LLC
Other - Org Name:HWP
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CROIX
Authorized Official - Middle Name:RONALD
Authorized Official - Last Name:COPPAGE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:570-369-7310
Mailing Address - Street 1:23 MADISON RD
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07004-2308
Mailing Address - Country:US
Mailing Address - Phone:570-369-7310
Mailing Address - Fax:973-556-1194
Practice Address - Street 1:23 MADISON RD STE A
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07004-2308
Practice Address - Country:US
Practice Address - Phone:316-776-4584
Practice Address - Fax:973-556-1194
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-15
Last Update Date:2021-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty