Provider Demographics
NPI:1003073495
Name:SHEKINAH INC.
Entity Type:Organization
Organization Name:SHEKINAH INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:ADE
Authorized Official - Middle Name:
Authorized Official - Last Name:JAGUN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-494-2062
Mailing Address - Street 1:1201 N WATSON RD
Mailing Address - Street 2:SUITE 221
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76006-6190
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1201 N WATSON RD
Practice Address - Street 2:SUITE 221
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76006-6120
Practice Address - Country:US
Practice Address - Phone:817-695-4100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-22
Last Update Date:2010-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0103976332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX6335600001Medicare NSC