Healthcare Provider Details

I. General information

NPI: 1184407751
Provider Name (Legal Business Name): SARAULLO ENTERPRISES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/16/2023
Last Update Date: 08/16/2023
Certification Date: 08/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 HARDING ST
TIMONIUM MD
21093-2235
US

IV. Provider business mailing address

2 HARDING ST
TIMONIUM MD
21093-2235
US

V. Phone/Fax

Practice location:
  • Phone: 443-900-5587
  • Fax:
Mailing address:
  • Phone: 443-900-5587
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
IdentifierR3918
Identifier TypeOTHER
Identifier StateMD
Identifier IssuerMARYLAND DEPARTMENT OF HEALTH OFFICE OF HEALTH CARE QUALITY

VIII. Authorized Official

Name: MS. DEBRA A SARAULLO
Title or Position: OWNER
Credential:
Phone: 443-900-5587