Provider Demographics
NPI:1174522841
Name:SHARE FOUNDATION
Entity type:Organization
Organization Name:SHARE FOUNDATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/COO
Authorized Official - Prefix:MRS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:D
Authorized Official - Last Name:STRINGFELLOW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:8708-819-0157
Mailing Address - Street 1:2301 CHAMPAGNOLLE ROAD
Mailing Address - Street 2:
Mailing Address - City:EL DORADO
Mailing Address - State:AR
Mailing Address - Zip Code:71730-4816
Mailing Address - Country:US
Mailing Address - Phone:870-862-0337
Mailing Address - Fax:870-862-0727
Practice Address - Street 1:2301 CHAMPAGNOLLE ROAD
Practice Address - Street 2:
Practice Address - City:EL DORADO
Practice Address - State:AR
Practice Address - Zip Code:71730-4816
Practice Address - Country:US
Practice Address - Phone:870-862-0337
Practice Address - Fax:870-862-0727
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-15
Last Update Date:2014-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARAR4388315D00000X, 251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
No315D00000XNursing & Custodial Care FacilitiesHospice, Inpatient
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR130816747Medicaid
SW21328OtherMEDICARE SUBMITTER ID
AR9862Medicare PIN
AR041522Medicare UPIN
AR130816747Medicaid