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General NPI Number Information
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NPI Number | 1225164312
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Entity Type | Organization
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Legal Business Name | AMERICAN DIABETIC SHOE ALLIANCES, INC
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Dates
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Enumeration Date | 02/26/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3129 TAMIAMI TRL SUITE E
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City | PORT CHARLOTTE
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State | FL
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Zip | 33952-8010
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Country | US
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Telephone | 941-235-7463
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Fax | 941-625-6898
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Provider Business Mailing Address
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Address Line | PO BOX 494983
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City | PORT CHARLOTTE
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State | FL
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Zip | 33949-4983
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Country | US
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Telephone | 941-235-7463
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Fax | 941-625-6898
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Authorized Official
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Title or Position | OWNER
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Name | MS. BETHANNE ALGIE
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Credential | LICENSED PEDORTHIST
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Telephone | 941-235-7463
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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