Provider Demographics
NPI:1508090085
Name:808 LOOP HOME HEALTH SERVICES
Entity Type:Organization
Organization Name:808 LOOP HOME HEALTH SERVICES
Other - Org Name:808 LOOP HOME HEALTH SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PSA
Authorized Official - Prefix:MS
Authorized Official - First Name:SHERRY
Authorized Official - Middle Name:SHAVON
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:MEDICAL CODER
Authorized Official - Phone:919-482-9674
Mailing Address - Street 1:104 HAZELWOOD CT
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:NC
Mailing Address - Zip Code:27565-5985
Mailing Address - Country:US
Mailing Address - Phone:919-482-9674
Mailing Address - Fax:
Practice Address - Street 1:104 HAZELWOOD CT
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:NC
Practice Address - Zip Code:27565-5985
Practice Address - Country:US
Practice Address - Phone:919-482-9674
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-12
Last Update Date:2009-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health