Provider Demographics
NPI:1093187767
Name:SAMPSON AND SMITH HOME HEALTH CARE, LLC
Entity Type:Organization
Organization Name:SAMPSON AND SMITH HOME HEALTH CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:CARRIE
Authorized Official - Middle Name:E
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:BA, CHHHA
Authorized Official - Phone:973-393-2338
Mailing Address - Street 1:1200 CLINTON AVE STE 230
Mailing Address - Street 2:
Mailing Address - City:IRVINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07111-2094
Mailing Address - Country:US
Mailing Address - Phone:973-372-2500
Mailing Address - Fax:973-372-2505
Practice Address - Street 1:1200 CLINTON AVE STE 230
Practice Address - Street 2:
Practice Address - City:IRVINGTON
Practice Address - State:NJ
Practice Address - Zip Code:07111-2094
Practice Address - Country:US
Practice Address - Phone:973-372-2500
Practice Address - Fax:973-372-2505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-21
Last Update Date:2015-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJHP0194500251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health