Organization
SHINE LLC
Active
Organization
SHINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BAMLAK ESHETEA (OWNER)
(571) 315-2059
Entity
Organization
Contact information
Practice address
1390 SOUTHSIDE DR STE 111B, SALEM, VA 24153-4652
(703) 298-8700
Mailing address
1390 SOUTHSIDE DR STE 111B, SALEM, VA 24153-4652
(571) 315-2059
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Enumeration date
11/01/2022
Last updated
07/11/2023
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