MEDICARE: CHILDREN'S SHOE WORLD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336S0011X	Specialty Pharmacy	MP00099	NV

General Provider Information

NPI Number	:	1306042841
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHILDREN'S SHOE WORLD

Provider Business Mailing Address
First Line	:	1924 E SAHARA AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89104-3843
Country	:	US
Telephone Number	:	702-457-5485
Fax Number	:	702-457-5516

Provider Business Practice Location Address
First Line	:	1924 E SAHARA AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89104-3843
Country	:	US
Telephone Number	:	702-457-5485
Fax Number	:	702-457-5516

Authorized Official
Title or Position	:	OWNER
Name	:	MR. CESAR A GALINDO SR.
Credential	:
Telephone Number	:	70245754895

Provider Enumeration Date	:	06/22/2007
Last Update Date	:	08/22/2020

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Directions to “CHILDREN'S SHOE WORLD ” Practice Location

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