Organization Name: | CARL'S FOOTWEAR |
NPI Number: | 1386792802 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JOEL BOUSEMA (PRESIDENT) |
Mailing Address: | 319 9th St Sheldon |
State: | IA US |
Postal Code: | 512011556 |
Phone Number: | 7123242623 |
Fax Number: | |
NPI Enumeration Date: | 01/08/2007 |
NPI Last Update Date: | 11/19/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | 71006602 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IA |
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 |