Provider Demographics
NPI:1891129300
Name:SHARE HOME HEALTH LLC
Entity Type:Organization
Organization Name:SHARE HOME HEALTH LLC
Other - Org Name:DBA COMPLETE HOME HEALTH OF STIGLER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:IREN
Authorized Official - Middle Name:C
Authorized Official - Last Name:EDWARDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-360-7014
Mailing Address - Street 1:508 E CONFEDERATE ST
Mailing Address - Street 2:
Mailing Address - City:WHITEFIELD
Mailing Address - State:OK
Mailing Address - Zip Code:74472-1703
Mailing Address - Country:US
Mailing Address - Phone:855-420-8225
Mailing Address - Fax:855-415-2862
Practice Address - Street 1:508 E CONFEDERATE ST
Practice Address - Street 2:
Practice Address - City:WHITEFIELD
Practice Address - State:OK
Practice Address - Zip Code:74472-1703
Practice Address - Country:US
Practice Address - Phone:855-420-8225
Practice Address - Fax:855-415-2862
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-03
Last Update Date:2014-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK377166Medicare PIN