Provider Demographics
NPI:1609420272
Name:TELEMEDICINE HOUSECALLS, LLC
Entity Type:Organization
Organization Name:TELEMEDICINE HOUSECALLS, LLC
Other - Org Name:SUGAR DOCTOR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL CODER AND BILLER
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:SHELDON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-748-1110
Mailing Address - Street 1:132 KIETA WAY
Mailing Address - Street 2:
Mailing Address - City:RADCLIFF
Mailing Address - State:KY
Mailing Address - Zip Code:40160-2105
Mailing Address - Country:US
Mailing Address - Phone:270-748-1110
Mailing Address - Fax:270-220-0531
Practice Address - Street 1:132 KIETA WAY
Practice Address - Street 2:
Practice Address - City:RADCLIFF
Practice Address - State:KY
Practice Address - Zip Code:40160-2105
Practice Address - Country:US
Practice Address - Phone:270-748-1110
Practice Address - Fax:270-220-0531
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-31
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100331710Medicaid