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General NPI Number Information
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NPI Number | 1578671541
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Entity Type | Organization
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Legal Business Name | SHOE COMFORT INC
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Dates
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Enumeration Date | 08/29/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 6632 RIDGE RD
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City | PORT RICHEY
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State | FL
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Zip | 34668-6837
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Country | US
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Telephone | 727-842-7693
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Fax | 727-842-8677
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Provider Business Mailing Address
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Address Line | 6632 RIDGE RD
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City | PORT RICHEY
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State | FL
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Zip | 34668-6837
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Country | US
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Telephone | 727-842-7693
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Fax | 727-842-8677
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Authorized Official
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Title or Position | OWNER
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Name | JOHN HNILICA
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Credential |
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Telephone | 727-842-7693
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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 | FL
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