Provider Demographics
NPI:1861124372
Name:SHURA, INCORPORATED
Entity type:Organization
Organization Name:SHURA, INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF BUSINESS/FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:TIYE
Authorized Official - Middle Name:
Authorized Official - Last Name:MULAZIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-660-7664
Mailing Address - Street 1:116 SLADE AVE
Mailing Address - Street 2:
Mailing Address - City:PIKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21208-4908
Mailing Address - Country:US
Mailing Address - Phone:443-660-7664
Mailing Address - Fax:410-413-6940
Practice Address - Street 1:116 SLADE AVE
Practice Address - Street 2:
Practice Address - City:PIKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21208-4908
Practice Address - Country:US
Practice Address - Phone:443-660-7664
Practice Address - Fax:410-413-6940
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-24
Last Update Date:2022-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management