Healthcare Provider Details

I. General information

NPI: 1346354206
Provider Name (Legal Business Name): BEST-MADE SHOES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2006
Last Update Date: 05/04/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5143 LIBERTY AVE
PITTSBURGH PA
15224-2217
US

IV. Provider business mailing address

5143 LIBERTY AVE
PITTSBURGH PA
15224-2217
US

V. Phone/Fax

Practice location:
  • Phone: 412-621-9363
  • Fax: 412-621-1501
Mailing address:
  • Phone: 412-621-9363
  • Fax: 412-621-1501

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: MR. EUGENE S ROSEN
Title or Position: OWNER
Credential: C.PED
Phone: 412-621-9367