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General NPI Number Information
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NPI Number | 1114024858
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Entity Type | Organization
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Legal Business Name | SHEPARDS CROOK NURSING AGENCY, INC.
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Dates
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Enumeration Date | 09/17/2006
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Last Update Date | 04/08/2016
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Provider Practice Location Address
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Address Line | 916 CREST RD SUITE 101
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City | PAMPA
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State | TX
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Zip | 79065
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Country | US
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Telephone | 806-665-0356
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Fax | 806-665-4245
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Provider Business Mailing Address
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Address Line | PO BOX 2234
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City | PAMPA
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State | TX
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Zip | 79066-2234
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Country | US
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Telephone | 806-665-0356
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Fax | 806-665-4245
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Authorized Official
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Title or Position | DON/ADMINISTRATOR
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Name | MICHAEL ELIZABETH CRUMP
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Credential | RN, BSN
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Telephone | 806-665-0356
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 001993
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 1993
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License Number State | TX
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