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General NPI Number Information
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NPI Number | 1356281216
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Entity Type | Organization
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Legal Business Name | GINOS SHOE STORE INC
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Dates
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Enumeration Date | 03/31/2026
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Last Update Date | 04/01/2026
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Provider Practice Location Address
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Address Line | 2437 SR 309 HWY
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City | DALLAS
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State | PA
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Zip | 18612-9251
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Country | US
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Telephone | 570-675-2029
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Fax |
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Provider Business Mailing Address
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Address Line | 2437 SR 309 HWY
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City | DALLAS
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State | PA
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Zip | 18612-9251
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Country | US
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Telephone | 570-675-2029
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | VINCENT GINOCCHETTI
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Credential |
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Telephone | 570-239-2882
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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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Taxonomy #2
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State |
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