Provider Demographics
NPI:1114296092
Name:KMS PROPERTIES LLC DBA SYNERGY HOMECARE
Entity Type:Organization
Organization Name:KMS PROPERTIES LLC DBA SYNERGY HOMECARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SHELLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:WAITES
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:205-987-0555
Mailing Address - Street 1:114 TRADE CENTER DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35244-1663
Mailing Address - Country:US
Mailing Address - Phone:205-987-0555
Mailing Address - Fax:888-743-6494
Practice Address - Street 1:114 TRADE CENTER DR
Practice Address - Street 2:SUITE A
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35244-1663
Practice Address - Country:US
Practice Address - Phone:205-987-0555
Practice Address - Fax:888-743-6494
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-21
Last Update Date:2011-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALNONLICENSE STATE251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health