MEDICARE: SHARE FOUNDATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	315D00000X	Inpatient Hospice	AR4388	AR
2	251G00000X	Community Based Hospice Care Agency	AR4388	AR

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	SW21328	OTHER		MEDICARE SUBMITTER ID

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1174522841
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SHARE FOUNDATION

Provider Business Mailing Address
First Line	:	2301 CHAMPAGNOLLE ROAD
Second Line	:
City	:	EL DORADO
State	:	AR
Zip	:	71730-4816
Country	:	US
Telephone Number	:	870-862-0337
Fax Number	:	870-862-0727

Provider Business Practice Location Address
First Line	:	2301 CHAMPAGNOLLE ROAD
Second Line	:
City	:	EL DORADO
State	:	AR
Zip	:	71730-4816
Country	:	US
Telephone Number	:	870-862-0337
Fax Number	:	870-862-0727

Authorized Official
Title or Position	:	PRESIDENT/COO
Name	:	MRS. LINDA D STRINGFELLOW
Credential	:
Telephone Number	:	87088190157

Provider Enumeration Date	:	07/15/2005
Last Update Date	:	07/03/2014

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Practice Location Address:

2301 CHAMPAGNOLLE RD
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Practice Fax:

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1881626877 — JORGE EDUARDO BILBAO MD
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1821207432 — DR. CESAR ALEJANDRO ABBUD-MENDEZ M.D.
Practice Location Address:

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Directions to “SHARE FOUNDATION ” Practice Location

Language	Start Address	Practice Location

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