Healthcare Provider Details

I. General information

NPI: 1316235096
Provider Name (Legal Business Name): ARCHMASTERS-ORTHOTICS,SHOES&FOOTCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2011
Last Update Date: 07/15/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 CREEKSIDE XING SUITE 1500
BRENTWOOD TN
37027-1062
US

IV. Provider business mailing address

101 CREEKSIDE XING SUITE 1500
BRENTWOOD TN
37027-1062
US

V. Phone/Fax

Practice location:
  • Phone: 615-370-3000
  • Fax: 615-370-3331
Mailing address:
  • Phone: 615-370-3000
  • Fax: 615-370-3331

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: DAVID SABLES
Title or Position: OWNER
Credential:
Phone: 615-370-3000