Organization Name: | FAIRMONT FOOT CENTER |
NPI Number: | 1093984403 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DAVID FERRERO (OWNER) |
Mailing Address: | 314 Fairmont Ave Fairmont |
State: | WV US |
Postal Code: | 265542713 |
Phone Number: | 3043671111 |
Fax Number: | 3043671128 |
NPI Enumeration Date: | 02/29/2008 |
NPI Last Update Date: | 08/24/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | 248 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WV |
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 |