Provider Demographics
NPI:1669963385
Name:SDX HOME CARE OPERATIONS, LLC
Entity type:Organization
Organization Name:SDX HOME CARE OPERATIONS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP OF FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:RUTH
Authorized Official - Middle Name:
Authorized Official - Last Name:AZANKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-621-9649
Mailing Address - Street 1:2575 WILLOW POINT WAY STE 107
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37931-3163
Mailing Address - Country:US
Mailing Address - Phone:865-214-6787
Mailing Address - Fax:
Practice Address - Street 1:2575 WILLOW POINT WAY STE 107
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37931-3163
Practice Address - Country:US
Practice Address - Phone:865-214-6787
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SDX HOME CARE OPERATIONS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-05-29
Last Update Date:2020-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNI000000022257253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care