Healthcare Provider Details

I. General information

NPI: 1093626277
Provider Name (Legal Business Name): SHIELD - DENVER HEALTH CARE CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 N CORCORAN ST FLR 5, STE 05-111
DURHAM NC
27701-5015
US

IV. Provider business mailing address

27911 FRANKLIN PKWY
VALENCIA CA
91355-4110
US

V. Phone/Fax

Practice location:
  • Phone: 661-294-4200
  • Fax:
Mailing address:
  • Phone: 661-294-4200
  • Fax: 661-294-1042

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: MR. MIKE SUOR
Title or Position: VICE PRESIDENT GENERAL MANAGER
Credential:
Phone: 661-294-4200