Provider Demographics
NPI:1639809759
Name:SUGAR MAGNOLIA HOME CARE
Entity type:Organization
Organization Name:SUGAR MAGNOLIA HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SHAY
Authorized Official - Middle Name:BABB
Authorized Official - Last Name:ARNETTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-578-2582
Mailing Address - Street 1:105 MARKS ST
Mailing Address - Street 2:
Mailing Address - City:SEABOARD
Mailing Address - State:NC
Mailing Address - Zip Code:27876-9600
Mailing Address - Country:US
Mailing Address - Phone:252-578-7178
Mailing Address - Fax:
Practice Address - Street 1:105 MARKS ST
Practice Address - Street 2:
Practice Address - City:SEABOARD
Practice Address - State:NC
Practice Address - Zip Code:27876-9600
Practice Address - Country:US
Practice Address - Phone:252-578-7178
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-13
Last Update Date:2022-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health