Provider Demographics
NPI:1063696078
Name:SARASOTA MEMORIAL HOME CARE INC
Entity type:Organization
Organization Name:SARASOTA MEMORIAL HOME CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:FAY
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MHA
Authorized Official - Phone:941-917-7730
Mailing Address - Street 1:6075 RAND BLVD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34238-5189
Mailing Address - Country:US
Mailing Address - Phone:941-917-7730
Mailing Address - Fax:941-917-1014
Practice Address - Street 1:8451 SHADE AVE
Practice Address - Street 2:BUILDING 2, SUITE 210
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34243-2878
Practice Address - Country:US
Practice Address - Phone:941-917-7730
Practice Address - Fax:941-917-1959
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-27
Last Update Date:2008-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL299992973251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health