Healthcare Provider Details
I. General information
NPI: 1770402711
Provider Name (Legal Business Name): THE SHEL STITCH COMPANY LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/14/2026
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5534 SAINT JOE RD
FORT WAYNE IN
46835-3328
US
IV. Provider business mailing address
5534 SAINT JOE RD
FORT WAYNE IN
46835-3328
US
V. Phone/Fax
- Phone: 317-766-6318
- Fax: 317-766-6318
- Phone: 317-766-6318
- Fax: 317-766-6318
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
BEIANA
KAY
SHELTON
Title or Position: OWNER/MANAGER
Credential: SHELTON
Phone: 317-766-6318