Provider Demographics
NPI:1609514678
Name:SAILORGIRL HEALTHCARE REGISTRY LLC
Entity Type:Organization
Organization Name:SAILORGIRL HEALTHCARE REGISTRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEANINE
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:941-302-6649
Mailing Address - Street 1:677 N WASHINGTON BLVD STE 12
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34236-4241
Mailing Address - Country:US
Mailing Address - Phone:941-932-4457
Mailing Address - Fax:
Practice Address - Street 1:677 N WASHINGTON BLVD STE 12
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34236-4241
Practice Address - Country:US
Practice Address - Phone:941-932-4457
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-20
Last Update Date:2022-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health