MEDICARE: YOUR FOOT FRIEND, INC.

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	332B00000X	Durable Medical Equipment & Medical Supplies

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1629070891
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	YOUR FOOT FRIEND, INC.

Provider Business Mailing Address
First Line	:	233 JOHNS ROAD
Second Line	:
City	:	MAXTON
State	:	NC
Zip	:	28364-1650
Country	:	US
Telephone Number	:	336-889-5909
Fax Number	:	910-390-9002

Provider Business Practice Location Address
First Line	:	233 JOHNS ROAD
Second Line	:
City	:	MAXTON
State	:	NC
Zip	:	28364-1650
Country	:	US
Telephone Number	:	336-889-5909
Fax Number	:	910-390-9002

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. JOHN ROBERT CLAY
Credential	:	C-PED.
Telephone Number	:	336-689-0116

Provider Enumeration Date	:	06/01/2005
Last Update Date	:	08/25/2022

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Directions to “YOUR FOOT FRIEND, INC. ” Practice Location

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