Provider Demographics
NPI:1477269561
Name:CAREGIVERS OF THE SHOALS LLC
Entity Type:Organization
Organization Name:CAREGIVERS OF THE SHOALS LLC
Other - Org Name:CAREGIVERS OF THE SHOALS LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:EXECUTIVE ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:L
Authorized Official - Last Name:PURYEAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-415-5575
Mailing Address - Street 1:522 COUNTY ROAD 122
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:AL
Mailing Address - Zip Code:35634-3594
Mailing Address - Country:US
Mailing Address - Phone:256-415-5575
Mailing Address - Fax:
Practice Address - Street 1:522 COUNTY ROAD 122
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:AL
Practice Address - Zip Code:35634-3594
Practice Address - Country:US
Practice Address - Phone:256-415-5575
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-23
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health