Healthcare Provider Details

I. General information

NPI: 1700019932
Provider Name (Legal Business Name): UNITED METHODIST HOME OF SHARON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/04/2009
Last Update Date: 09/14/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27 HOSPITAL HILL RD
SHARON CT
06069
US

IV. Provider business mailing address

27 HOSPITAL HILL RD
SHARON CT
06069
US

V. Phone/Fax

Practice location:
  • Phone: 860-364-1002
  • Fax: 860-364-0237
Mailing address:
  • Phone: 860-364-1002
  • Fax: 860-364-0237

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number2257
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number2257
License Number StateCT
# 3
Primary TaxonomyY
Taxonomy Code261QR0401X
TaxonomyComprehensive Outpatient Rehabilitation Facility (CORF)
License Number2257
License Number StateCT
# 4
Primary TaxonomyN
Taxonomy Code261QX0100X
TaxonomyOccupational Medicine Clinic/Center
License Number2257
License Number StateCT

VIII. Authorized Official

Name: DAVID LAWLOR
Title or Position: TREASURER
Credential:
Phone: 203-944-8285