Provider Demographics
NPI:1770006777
Name:SAND BAR HOMECARE LLC
Entity type:Organization
Organization Name:SAND BAR HOMECARE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:PEARCE
Authorized Official - Last Name:MELCHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:802-881-6552
Mailing Address - Street 1:56 W TWIN OAKS TER STE 7
Mailing Address - Street 2:
Mailing Address - City:SOUTH BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05403-7106
Mailing Address - Country:US
Mailing Address - Phone:802-862-8777
Mailing Address - Fax:802-862-2788
Practice Address - Street 1:56 W TWIN OAKS TER STE 7
Practice Address - Street 2:
Practice Address - City:SOUTH BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05403-7106
Practice Address - Country:US
Practice Address - Phone:802-862-8777
Practice Address - Fax:802-862-2788
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care