Provider Demographics
NPI:1659551976
Name:SHARON LOUANNE HUGHES
Entity Type:Organization
Organization Name:SHARON LOUANNE HUGHES
Other - Org Name:NATIONAL COLON HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:LOUANNE
Authorized Official - Last Name:HUGHES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-241-0651
Mailing Address - Street 1:PO BOX 991717
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96099-1717
Mailing Address - Country:US
Mailing Address - Phone:888-241-0651
Mailing Address - Fax:866-278-8556
Practice Address - Street 1:3310 CHURN CREEK RD
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96002-2502
Practice Address - Country:US
Practice Address - Phone:888-241-0651
Practice Address - Fax:866-278-8556
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-05
Last Update Date:2018-09-21
Deactivation Date:2008-02-26
Deactivation Code:
Reactivation Date:2008-04-02
Provider Licenses
StateLicense IDTaxonomies
CA48625332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADME03018FMedicaid
CADME03018FMedicaid