Provider Demographics
NPI:1891541843
Name:SHARP MIND AND MEDICAL LLC
Entity type:Organization
Organization Name:SHARP MIND AND MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:HELEN
Authorized Official - Middle Name:
Authorized Official - Last Name:SHARP
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:210-391-7642
Mailing Address - Street 1:5700 W RASPBERRY LOOP
Mailing Address - Street 2:
Mailing Address - City:WASILLA
Mailing Address - State:AK
Mailing Address - Zip Code:99623-9451
Mailing Address - Country:US
Mailing Address - Phone:210-391-7642
Mailing Address - Fax:
Practice Address - Street 1:5700 W RASPBERRY LOOP
Practice Address - Street 2:
Practice Address - City:WASILLA
Practice Address - State:AK
Practice Address - Zip Code:99623-9451
Practice Address - Country:US
Practice Address - Phone:210-391-7642
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-29
Last Update Date:2024-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care