MEDICARE: SHEKINAH INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies	0103976	TX

General Provider Information

NPI Number	:	1003073495
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SHEKINAH INC.

Provider Business Mailing Address
First Line	:	1201 N WATSON RD
Second Line	:	SUITE 221
City	:	ARLINGTON
State	:	TX
Zip	:	76006-6190
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1201 N WATSON RD
Second Line	:	SUITE 221
City	:	ARLINGTON
State	:	TX
Zip	:	76006-6120
Country	:	US
Telephone Number	:	817-695-4100
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR OF OPERATIONS
Name	:	MR. ADE JAGUN
Credential	:
Telephone Number	:	817-494-2062

Provider Enumeration Date	:	05/22/2008
Last Update Date	:	07/06/2010

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Directions to “SHEKINAH INC. ” Practice Location

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