Healthcare Provider Details

I. General information

NPI: 1427983048
Provider Name (Legal Business Name): HARBOUR SHEILD INSURANCE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

909 ILLINOIS ST
SHERIDAN WY
82801-5234
US

IV. Provider business mailing address

909 ILLINOIS ST
SHERIDAN WY
82801-5234
US

V. Phone/Fax

Practice location:
  • Phone: 440-675-1691
  • Fax: 888-739-0795
Mailing address:
  • Phone: 440-675-1691
  • Fax: 888-739-0795

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1835P1400X
TaxonomyPain Management Pharmacist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MR. VIKALP KUMAR
Title or Position: CEO
Credential:
Phone: 440-675-1691