Provider Demographics
NPI:1295918415
Name:SHERWOOD CLINICAL
Entity type:Organization
Organization Name:SHERWOOD CLINICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:J
Authorized Official - Last Name:COULTER
Authorized Official - Suffix:
Authorized Official - Credentials:RN, CRNI
Authorized Official - Phone:706-776-9127
Mailing Address - Street 1:16 PEACHTREE ST
Mailing Address - Street 2:
Mailing Address - City:CARTERSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30120-3981
Mailing Address - Country:US
Mailing Address - Phone:678-721-9211
Mailing Address - Fax:
Practice Address - Street 1:16 PEACHTREE ST
Practice Address - Street 2:
Practice Address - City:CARTERSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30120-3981
Practice Address - Country:US
Practice Address - Phone:678-721-9211
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SHERWOOD CLINICAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-12-11
Last Update Date:2007-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPHRE008565332BP3500X
PHRE0085653336H0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition