Provider Demographics
NPI:1871174813
Name:HUGHES, SHARON THOMAS (PERSONAL CARE HOME)
Entity type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:THOMAS
Last Name:HUGHES
Suffix:
Gender:F
Credentials:PERSONAL CARE HOME
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5222 VERDUN DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31907-6760
Mailing Address - Country:US
Mailing Address - Phone:762-436-0926
Mailing Address - Fax:
Practice Address - Street 1:4 MELODY CT
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31907-4508
Practice Address - Country:US
Practice Address - Phone:762-436-0926
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-20
Last Update Date:2021-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA009814310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility