Provider Demographics
NPI:1760956494
Name:SACRAMENTO HOME MEDICAL LLC
Entity Type:Organization
Organization Name:SACRAMENTO HOME MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:RUSSELL
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:STRINGFELLOW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-903-3067
Mailing Address - Street 1:4141 NORTHGATE BLVD STE 1B
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95834-1231
Mailing Address - Country:US
Mailing Address - Phone:916-692-5810
Mailing Address - Fax:916-290-0574
Practice Address - Street 1:4141 NORTHGATE BLVD STE 1B
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95834-1231
Practice Address - Country:US
Practice Address - Phone:916-692-5810
Practice Address - Fax:916-290-0574
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-16
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies