Provider Demographics
NPI:1942976097
Name:POOE, SAMMY T
Entity Type:Individual
Prefix:
First Name:SAMMY
Middle Name:T
Last Name:POOE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2891 ARROWSMITH DR
Mailing Address - Street 2:
Mailing Address - City:REYNOLDSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43068-5049
Mailing Address - Country:US
Mailing Address - Phone:614-735-3339
Mailing Address - Fax:
Practice Address - Street 1:2891 ARROWSMITH DR
Practice Address - Street 2:
Practice Address - City:REYNOLDSBURG
Practice Address - State:OH
Practice Address - Zip Code:43068-5049
Practice Address - Country:US
Practice Address - Phone:614-735-3339
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-18
Last Update Date:2021-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator