Provider Demographics
NPI:1720555303
Name:SHAMMAH HEALTH CARE SERVICES, INC
Entity Type:Organization
Organization Name:SHAMMAH HEALTH CARE SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FACILITATOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:SHELIA
Authorized Official - Middle Name:F
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:NURSE
Authorized Official - Phone:815-299-0134
Mailing Address - Street 1:518 N COURT ST
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61103-6808
Mailing Address - Country:US
Mailing Address - Phone:815-299-0134
Mailing Address - Fax:
Practice Address - Street 1:518 N COURT ST
Practice Address - Street 2:
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61103-6808
Practice Address - Country:US
Practice Address - Phone:815-299-0134
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-31
Last Update Date:2018-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health