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General NPI Number Information
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NPI Number | 1588034862
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Entity Type | Organization
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Legal Business Name | SAMSHINES LLC
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Dates
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Enumeration Date | 09/30/2015
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Last Update Date | 09/30/2015
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Provider Practice Location Address
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Address Line | 5501 BRIXTON RD
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City | WILLIAMSBURG
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State | VA
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Zip | 23185-3868
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Country | US
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Telephone | 757-570-3932
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 7011
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City | WILLIAMSBURG
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State | VA
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Zip | 23188-5233
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Country | US
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Telephone | 757-570-3932
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. SHARRON LORRAINE TAYLOR-HAGGETT
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Credential | ATP
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Telephone | 757-570-3932
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | S5754090
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 171WH0202X
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Taxonomy Name | Home Modifications Contractor
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License Number | S5754090
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number | S5754090
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License Number State | VA
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