Provider Demographics
NPI:1508141649
Name:SANDRA'S HOME HEALTH CARE
Entity Type:Organization
Organization Name:SANDRA'S HOME HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-643-2872
Mailing Address - Street 1:3540 SUMMER AVE
Mailing Address - Street 2:SUITE 404
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38122-3600
Mailing Address - Country:US
Mailing Address - Phone:901-324-6164
Mailing Address - Fax:901-324-6164
Practice Address - Street 1:3540 SUMMER AVE
Practice Address - Street 2:SUITE 404
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38122-3600
Practice Address - Country:US
Practice Address - Phone:901-324-6164
Practice Address - Fax:901-324-6164
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-20
Last Update Date:2011-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1000000009371251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health