Healthcare Provider Details

I. General information

NPI: 1134110331
Provider Name (Legal Business Name): SHME, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/04/2005
Last Update Date: 11/22/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

623 W MAIN ST
WALNUT RIDGE AR
72476-1848
US

IV. Provider business mailing address

PO BOX 528
WALNUT RIDGE AR
72476-0528
US

V. Phone/Fax

Practice location:
  • Phone: 870-886-2002
  • Fax:
Mailing address:
  • Phone: 870-886-2002
  • Fax: 870-886-1863

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MRS. ERIKA DAWN SHIELDS
Title or Position: PRESIDENT
Credential:
Phone: 870-886-2002