Provider Demographics
NPI:1891529343
Name:SHAMARIE HOME HEALTH, LLC
Entity type:Organization
Organization Name:SHAMARIE HOME HEALTH, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:INDEPENDENT PROVIDER
Authorized Official - Prefix:MISS
Authorized Official - First Name:AMBER
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:COLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:567-281-9209
Mailing Address - Street 1:PO BOX 17248
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45417-0248
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1568 BLAIRWOOD AVE
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45417-6030
Practice Address - Country:US
Practice Address - Phone:567-281-9209
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-28
Last Update Date:2024-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health