Provider Demographics
NPI:1659503233
Name:SHINAMERICA
Entity Type:Organization
Organization Name:SHINAMERICA
Other - Org Name:ULTI MED
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:TOM
Authorized Official - Middle Name:
Authorized Official - Last Name:ERICKSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-291-7909
Mailing Address - Street 1:PO BOX 476
Mailing Address - Street 2:710 4TH STREET
Mailing Address - City:DE SMET
Mailing Address - State:SD
Mailing Address - Zip Code:57231
Mailing Address - Country:US
Mailing Address - Phone:605-854-3434
Mailing Address - Fax:605-854-9234
Practice Address - Street 1:710 4TH STREET
Practice Address - Street 2:
Practice Address - City:DE SMET
Practice Address - State:SD
Practice Address - Zip Code:57231
Practice Address - Country:US
Practice Address - Phone:605-854-3434
Practice Address - Fax:605-854-9234
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-17
Last Update Date:2009-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BD1200XSuppliersDurable Medical Equipment & Medical SuppliesDialysis Equipment & Supplies