MEDICARE: PORT CITY REMODELING

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	171WH0202X	Home Modifications Contractor

General Provider Information

NPI Number	:	1396602470
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PORT CITY REMODELING

Provider Business Mailing Address
First Line	:	482 OCKLEY DR
Second Line	:
City	:	SHREVEPORT
State	:	LA
Zip	:	71105-2920
Country	:	US
Telephone Number	:	318-218-6453
Fax Number	:

Provider Business Practice Location Address
First Line	:	482 OCKLEY DR
Second Line	:
City	:	SHREVEPORT
State	:	LA
Zip	:	71105-2920
Country	:	US
Telephone Number	:	318-218-6453
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	THOMAS KENDRICK
Credential	:
Telephone Number	:	318-218-6453

Provider Enumeration Date	:	01/08/2026
Last Update Date	:	02/25/2026

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Directions to “PORT CITY REMODELING ” Practice Location

Language	Start Address	Practice Location

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