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General NPI Number Information
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NPI Number | 1891164828
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Entity Type | Organization
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Legal Business Name | SHADAI HEALTHCARE SERVICES LLC
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Dates
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Enumeration Date | 09/21/2015
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Last Update Date | 12/16/2022
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Provider Practice Location Address
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Address Line | 22 N 32ND STREET 22 & 24
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City | CAMP HILL
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State | PA
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Zip | 17011-2917
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Country | US
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Telephone | 717-303-0272
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Fax | 717-303-0273
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Provider Business Mailing Address
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Address Line | 22 N 32ND STREET 22 & 24
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City | CAMP HILL
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State | PA
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Zip | 17011
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Country | US
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Telephone | 717-303-0272
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Fax | 717-303-0273
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Authorized Official
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Title or Position | REGISTERED NURSE
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Name | MRS. EVELYN SOSU
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Credential | RN, BSN
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Telephone | 717-379-3269
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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 | 06070501
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License Number State | PA
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