Provider Demographics
NPI:1619986775
Name:SHM LLC
Entity Type:Organization
Organization Name:SHM LLC
Other - Org Name:SWAN VIEW MEDICAL SUPPLY LLC
Other - Org Type:Other Name
Authorized Official - Title/Position:COOWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:R
Authorized Official - Last Name:ROHDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:309-664-7930
Mailing Address - Street 1:PO BOX 252
Mailing Address - Street 2:
Mailing Address - City:SWANSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:28584-0252
Mailing Address - Country:US
Mailing Address - Phone:910-325-1300
Mailing Address - Fax:910-325-1500
Practice Address - Street 1:675 W CORBETT AVE STE 1
Practice Address - Street 2:
Practice Address - City:SWANSBORO
Practice Address - State:NC
Practice Address - Zip Code:28584-8451
Practice Address - Country:US
Practice Address - Phone:910-325-1300
Practice Address - Fax:910-325-1500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-07
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC01178332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5760980001Medicare NSC