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General NPI Number Information
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NPI Number | 1356245419
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Entity Type | Organization
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Legal Business Name | SHIELD SUPPORT BROKER LLC
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Dates
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Enumeration Date | 10/05/2026
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Last Update Date | 10/05/2026
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Provider Practice Location Address
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Address Line | 148 S HARTLEY ST
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City | YORK
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State | PA
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Zip | 17401-3744
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Country | US
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Telephone | 717-841-2592
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Fax |
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Provider Business Mailing Address
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Address Line | 148 S HARTLEY ST
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City | YORK
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State | PA
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Zip | 17401-3744
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Country | US
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Telephone | 717-841-2592
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | RASHIN OSMAN
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Credential | LSW
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Telephone | 717-841-2592
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251X00000X
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Taxonomy Name | Supports Brokerage Agency
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License Number |
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License Number State | NULL
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