Organization Name: | TAYLORED SHOES |
NPI Number: | 1184993941 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KEITH TAYLOR (OWNER/C.PED) |
Mailing Address: | 1025 5th St Novato |
State: | CA US |
Postal Code: | 949452413 |
Phone Number: | 7072900627 |
Fax Number: | |
NPI Enumeration Date: | 12/23/2011 |
NPI Last Update Date: | 02/16/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
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 |