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General NPI Number Information
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NPI Number | 1720555303
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Entity Type | Organization
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Legal Business Name | SHAMMAH HEALTH CARE SERVICES, INC
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Dates
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Enumeration Date | 10/31/2018
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Last Update Date | 10/31/2018
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Provider Practice Location Address
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Address Line | 518 N COURT ST
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City | ROCKFORD
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State | IL
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Zip | 61103-6808
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Country | US
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Telephone | 815-299-0134
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Fax |
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Provider Business Mailing Address
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Address Line | 518 N COURT ST
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City | ROCKFORD
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State | IL
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Zip | 61103-6808
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Country | US
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Telephone | 815-299-0134
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Fax |
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Authorized Official
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Title or Position | FACILITATOR
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Name | MISS SHELIA F BROWN
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Credential | NURSE
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Telephone | 815-299-0134
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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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