Healthcare Provider Details
I. General information
NPI: 1184210593
Provider Name (Legal Business Name): SAPPHIRE HOME HEALTH CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/19/2020
Last Update Date: 05/23/2025
Certification Date: 05/23/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
445 DEXTER AVE
MONTGOMERY AL
36104-3775
US
IV. Provider business mailing address
1315 MILSTEAD RD NE STE 101
CONYERS GA
30012-3824
US
V. Phone/Fax
- Phone: 334-557-7042
- Fax: 470-300-7778
- Phone: 470-217-8445
- Fax: 470-300-7778
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251F00000X |
| Taxonomy | Home Infusion Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251T00000X |
| Taxonomy | PACE Provider Organization |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 253Z00000X |
| Taxonomy | In Home Supportive Care Agency |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ELLA
STEPHENSON
Title or Position: ADMINISTRATOR
Credential: RN
Phone: 470-217-8445