=====================================================
General NPI Number Information
=====================================================
NPI Number | 1245636661
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SHARON'S HOMECARE SERVICES
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/12/2014
-----------------------------------------------------
Last Update Date | 11/12/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 330 ROCKWELL AVE
-----------------------------------------------------
City | BLOOMFIELD
-----------------------------------------------------
State | CT
-----------------------------------------------------
Zip | 06002-3147
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 860-833-3756
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 330 ROCKWELL AVE
-----------------------------------------------------
City | BLOOMFIELD
-----------------------------------------------------
State | CT
-----------------------------------------------------
Zip | 06002-3147
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 860-833-3756
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR
-----------------------------------------------------
Name | MS. LELIETH FURZE
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 860-462-8000
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 253Z00000X
-----------------------------------------------------
Taxonomy Name | In Home Supportive Care Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | CT
-----------------------------------------------------