Provider Demographics
NPI:1699059774
Name:SHOALS SENIOR SOLUTIONS
Entity type:Organization
Organization Name:SHOALS SENIOR SOLUTIONS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:FRANCHISE OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAMELLA
Authorized Official - Middle Name:G
Authorized Official - Last Name:HODGES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-764-4316
Mailing Address - Street 1:2703 DARBY DR
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:AL
Mailing Address - Zip Code:35630-1521
Mailing Address - Country:US
Mailing Address - Phone:256-764-4316
Mailing Address - Fax:
Practice Address - Street 1:2703 DARBY DR
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:AL
Practice Address - Zip Code:35630-1521
Practice Address - Country:US
Practice Address - Phone:256-764-4316
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-06
Last Update Date:2011-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care