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General NPI Number Information
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NPI Number | 1295918415
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Entity Type | Organization
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Legal Business Name | SHERWOOD CLINICAL
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Dates
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Enumeration Date | 12/11/2007
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Last Update Date | 12/11/2007
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Provider Practice Location Address
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Address Line | 16 PEACHTREE ST
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City | CARTERSVILLE
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State | GA
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Zip | 30120-3981
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Country | US
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Telephone | 678-721-9211
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Fax |
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Provider Business Mailing Address
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Address Line | 16 PEACHTREE ST
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City | CARTERSVILLE
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State | GA
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Zip | 30120-3981
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Country | US
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Telephone | 678-721-9211
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Fax |
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Authorized Official
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Title or Position | CHIEF OPERATING OFFICER
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Name | MS. KAREN J COULTER
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Credential | RN, CRNI
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Telephone | 706-776-9127
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BP3500X
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Taxonomy Name | Parenteral & Enteral Nutrition Supplies (DME)
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License Number | PHRE008565
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 3336H0001X
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Taxonomy Name | Home Infusion Therapy Pharmacy
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License Number | PHRE008565
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License Number State |
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