Provider Demographics
NPI:1902414352
Name:SHUNAMMITE HOME CARE LLC
Entity Type:Organization
Organization Name:SHUNAMMITE HOME CARE LLC
Other - Org Name:SHUNAMMITE HOME CARE LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:KAMGA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:844-440-0002
Mailing Address - Street 1:1648 BAYLAND ST
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78664-3746
Mailing Address - Country:US
Mailing Address - Phone:512-297-8312
Mailing Address - Fax:
Practice Address - Street 1:1648 BAYLAND ST
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78664-3746
Practice Address - Country:US
Practice Address - Phone:512-297-8312
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-21
Last Update Date:2023-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Multi-Specialty
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)Group - Multi-Specialty
No344600000XTransportation ServicesTaxiGroup - Multi-Specialty
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty
No376K00000XNursing Service Related ProvidersNurse's AideGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX28176971Medicaid