=====================================================
General NPI Number Information
=====================================================
NPI Number | 1881611622
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SAXTON & BREWER, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/17/2006
-----------------------------------------------------
Last Update Date | 02/11/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1050 N UNION ST
-----------------------------------------------------
City | STOCKTON
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95205-4118
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 209-463-8005
-----------------------------------------------------
Fax | 209-463-8035
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1050 N UNION ST
-----------------------------------------------------
City | STOCKTON
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95205-4118
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 209-463-8005
-----------------------------------------------------
Fax | 209-463-8035
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ADMINISTRATOR
-----------------------------------------------------
Name | CURTIS ERIC SAXTON
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 209-463-8015
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | 100000660
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------