Healthcare Provider Details

I. General information

NPI: 1417522434
Provider Name (Legal Business Name): SHIRLEY CARES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2021
Last Update Date: 05/21/2021
Certification Date: 05/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 E BARTHMAN AVE
COLUMBUS OH
43207
US

IV. Provider business mailing address

330 E BARTHMAN AVE
COLUMBUS OH
43207
US

V. Phone/Fax

Practice location:
  • Phone: 614-980-9578
  • Fax:
Mailing address:
  • Phone: 614-980-9578
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number StateNULL

VIII. Authorized Official

Name: PAMELA RAMMAGE
Title or Position: CEO
Credential:
Phone: 619-980-9578