Provider Demographics
NPI:1013113240
Name:SHALOM EQUIPMENT,INC.
Entity Type:Organization
Organization Name:SHALOM EQUIPMENT,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MISS
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:M
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-676-3987
Mailing Address - Street 1:2277A WOODWARD AVE
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71103-3547
Mailing Address - Country:US
Mailing Address - Phone:318-676-3987
Mailing Address - Fax:318-676-3988
Practice Address - Street 1:2277A WOODWARD AVE
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71103-3547
Practice Address - Country:US
Practice Address - Phone:318-676-3987
Practice Address - Fax:318-676-3988
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-25
Last Update Date:2007-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5915490001Medicare PIN