Provider Demographics
NPI:1588034862
Name:SAMSHINES LLC
Entity Type:Organization
Organization Name:SAMSHINES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SHARRON
Authorized Official - Middle Name:LORRAINE
Authorized Official - Last Name:TAYLOR-HAGGETT
Authorized Official - Suffix:
Authorized Official - Credentials:ATP
Authorized Official - Phone:757-570-3932
Mailing Address - Street 1:PO BOX 7011
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23188-5233
Mailing Address - Country:US
Mailing Address - Phone:757-570-3932
Mailing Address - Fax:
Practice Address - Street 1:5501 BRIXTON RD
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23185-3868
Practice Address - Country:US
Practice Address - Phone:757-570-3932
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-30
Last Update Date:2015-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAS5754090171WH0202X, 174400000X, 332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No171WH0202XOther Service ProvidersContractorHome ModificationsGroup - Multi-Specialty
No174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty