Provider Demographics
NPI:1578993291
Name:HEALTHCARE CERTIFICATIONS, LLC
Entity Type:Organization
Organization Name:HEALTHCARE CERTIFICATIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:WINSTON
Authorized Official - Middle Name:
Authorized Official - Last Name:SHIELDS
Authorized Official - Suffix:
Authorized Official - Credentials:BSN, RN
Authorized Official - Phone:501-551-1666
Mailing Address - Street 1:3721 IDLEWILD AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72116-8237
Mailing Address - Country:US
Mailing Address - Phone:501-551-1666
Mailing Address - Fax:501-771-2383
Practice Address - Street 1:3721 IDLEWILD AVE
Practice Address - Street 2:
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72116-8237
Practice Address - Country:US
Practice Address - Phone:501-551-1666
Practice Address - Fax:501-771-2383
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-15
Last Update Date:2013-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARR81105261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service