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General NPI Number Information
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NPI Number | 1376106062
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Entity Type | Organization
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Legal Business Name | SHAMROCK HEALTHCARE SERVICES
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Dates
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Enumeration Date | 04/17/2019
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Last Update Date | 04/17/2019
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Provider Practice Location Address
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Address Line | 28000 S WESTERN AVE UNIT 508
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City | SAN PEDRO
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State | CA
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Zip | 90732-1214
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Country | US
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Telephone | 310-800-8842
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Fax |
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Provider Business Mailing Address
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Address Line | 3400 COTTAGE WAY STE G2635
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City | SACRAMENTO
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State | CA
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Zip | 95825-1474
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Country | US
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Telephone | 310-800-8842
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | STELLA OPARAJI
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Credential |
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Telephone | 310-800-8842
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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 |
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License Number State |
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