Healthcare Provider Details

I. General information

NPI: 1508996877
Provider Name (Legal Business Name): HEALTH SHIELD, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/06/2007
Last Update Date: 08/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4333 SHREVEPORT HWY
PINEVILLE LA
71360-3828
US

IV. Provider business mailing address

PO BOX 8055
ALEXANDRIA LA
71306-1055
US

V. Phone/Fax

Practice location:
  • Phone: 318-484-9488
  • Fax: 318-619-9766
Mailing address:
  • Phone: 318-445-6470
  • Fax: 318-445-6422

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: MR. JAMES E. RICHARDSON JR.
Title or Position: CEO
Credential:
Phone: 318-445-6470