Healthcare Provider Details

I. General information

NPI: 1518720168
Provider Name (Legal Business Name): SAPPHIRE HOME HEALTH CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2024
Last Update Date: 05/20/2024
Certification Date: 05/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1315 MILSTEAD RD NE STE 102
CONYERS GA
30012-3824
US

IV. Provider business mailing address

1315 MILSTEAD RD NE STE 102
CONYERS GA
30012-3824
US

V. Phone/Fax

Practice location:
  • Phone: 470-217-8445
  • Fax: 470-300-7778
Mailing address:
  • Phone: 470-217-8445
  • Fax: 470-300-7778

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QI0500X
TaxonomyInfusion Therapy Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: ELLA WEAVER-STEPHENSON
Title or Position: ADMINISTRATOR
Credential: RN
Phone: 470-217-8445