Organization Name: | FOOTSTEPS,LLC |
NPI Number: | 1053321711 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CHRISTOPHER FORMANEK (PRESIDENT) |
Mailing Address: | 2647 S Riverview Blvd Suite 316 Gonzales |
State: | LA US |
Postal Code: | 707375021 |
Phone Number: | 2257560034 |
Fax Number: | 2257560708 |
NPI Enumeration Date: | 08/08/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | PD321R |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | LA |
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 |