Provider Demographics
NPI:1851948251
Name:SISTERCARE INC
Entity Type:Organization
Organization Name:SISTERCARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALLYSON
Authorized Official - Middle Name:H
Authorized Official - Last Name:MOSES
Authorized Official - Suffix:
Authorized Official - Credentials:AO
Authorized Official - Phone:404-734-0860
Mailing Address - Street 1:PO BOX 125
Mailing Address - Street 2:
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30078-0125
Mailing Address - Country:US
Mailing Address - Phone:404-734-0860
Mailing Address - Fax:
Practice Address - Street 1:5471 MEMORIAL DR STE J1
Practice Address - Street 2:
Practice Address - City:STONE MOUNTAIN
Practice Address - State:GA
Practice Address - Zip Code:30083-3241
Practice Address - Country:US
Practice Address - Phone:404-734-0860
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-20
Last Update Date:2019-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health