MEDICARE: SHELTON TECHNOLOGIES AND RESOURCES LLC

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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1720374358
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SHELTON TECHNOLOGIES AND RESOURCES LLC

Provider Business Mailing Address
First Line	:	322 E PINE ST
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33801-4969
Country	:	US
Telephone Number	:	863-603-7827
Fax Number	:	863-603-0255

Provider Business Practice Location Address
First Line	:	322 E PINE ST
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33801-4969
Country	:	US
Telephone Number	:	863-603-7827
Fax Number	:	863-603-0255

Authorized Official
Title or Position	:	OWNER/PRESIDENT
Name	:	KEVIN M SHELTON
Credential	:
Telephone Number	:	863-603-7827

Provider Enumeration Date	:	06/22/2011
Last Update Date	:	01/19/2024

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