Provider Demographics
NPI:1275770620
Name:SHAMA PULMONARY REHAB. CENTER INC.
Entity Type:Organization
Organization Name:SHAMA PULMONARY REHAB. CENTER INC.
Other - Org Name:SHAMA RESPIRATORY SERV'S & HME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:C
Authorized Official - Last Name:FOURROUX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-224-0380
Mailing Address - Street 1:102 N HYATT ST
Mailing Address - Street 2:
Mailing Address - City:MONTICELLO
Mailing Address - State:AR
Mailing Address - Zip Code:71655-4022
Mailing Address - Country:US
Mailing Address - Phone:870-224-0380
Mailing Address - Fax:870-224-0382
Practice Address - Street 1:212 E JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:OAK GROVE
Practice Address - State:LA
Practice Address - Zip Code:71263-2535
Practice Address - Country:US
Practice Address - Phone:318-428-8233
Practice Address - Fax:318-428-3424
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SHAMA PULMONARY REHAB. CENTER, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-01-07
Last Update Date:2009-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LALT3348332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies