Provider Demographics
NPI:1417312570
Name:SHARON L CHAMBERS INS AGY INC
Entity Type:Organization
Organization Name:SHARON L CHAMBERS INS AGY INC
Other - Org Name:STATE FARM INSURANCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AGENT
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:LAVERNE
Authorized Official - Last Name:CHAMBERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:219-981-3111
Mailing Address - Street 1:5275 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:GARY
Mailing Address - State:IN
Mailing Address - Zip Code:46410-1552
Mailing Address - Country:US
Mailing Address - Phone:219-981-3111
Mailing Address - Fax:219-981-3115
Practice Address - Street 1:5275 BROADWAY
Practice Address - Street 2:
Practice Address - City:GARY
Practice Address - State:IN
Practice Address - Zip Code:46410-1552
Practice Address - Country:US
Practice Address - Phone:219-981-3111
Practice Address - Fax:219-981-3115
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-16
Last Update Date:2015-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN1691280251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare