| Organization Name: | SHORELINE FOOT & ANKLE CENTER, PC |
| NPI Number: | 1013226463 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DARREN J COURTRIGHT (OWNER) |
| Mailing Address: | 5 Pequot Park Rd Suite 201 Westbrook |
| State: | CT US |
| Postal Code: | 064982856 |
| Phone Number: | 8604373737 |
| Fax Number: | 8604370530 |
| NPI Enumeration Date: | 10/04/2010 |
| NPI Last Update Date: | 03/27/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332B00000X |
| License Number: | 000607 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CT |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |