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General NPI Number Information
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NPI Number | 1497713663
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Entity Type | Organization
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Legal Business Name | MCLELLAND SHOES INC
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Dates
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Enumeration Date | 05/03/2006
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Last Update Date | 03/04/2008
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Provider Practice Location Address
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Address Line | 119 W BROAD ST
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City | STATESVILLE
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State | NC
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Zip | 28677-5257
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Country | US
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Telephone | 704-873-7935
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Fax | 704-873-7943
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Provider Business Mailing Address
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Address Line | 119 W BROAD ST
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City | STATESVILLE
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State | NC
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Zip | 28677-5257
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Country | US
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Telephone | 704-873-7935
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Fax | 704-873-7943
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JAMES GODFREY MCLELLAND JR.
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Credential | C.PED
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Telephone | 704-873-7935
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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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