Provider Demographics
NPI:1790292852
Name:OWEN HEALTH CARE
Entity Type:Organization
Organization Name:OWEN HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:ERO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-258-7796
Mailing Address - Street 1:2041 SPRINGFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:VAUXHALL
Mailing Address - State:NJ
Mailing Address - Zip Code:07088-1220
Mailing Address - Country:US
Mailing Address - Phone:908-258-7796
Mailing Address - Fax:908-258-7798
Practice Address - Street 1:2041 SPRINGFIELD AVE
Practice Address - Street 2:
Practice Address - City:VAUXHALL
Practice Address - State:NJ
Practice Address - Zip Code:07088-1220
Practice Address - Country:US
Practice Address - Phone:908-258-7796
Practice Address - Fax:908-258-7798
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-10
Last Update Date:2018-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0433462Medicaid