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General NPI Number Information
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NPI Number | 1578708590
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Entity Type | Organization
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Legal Business Name | GOOD FEET - BIRMINGHAM, LLC
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Dates
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Enumeration Date | 12/04/2008
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Last Update Date | 12/04/2008
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Provider Practice Location Address
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Address Line | 3411 COLONNADE PKWY SUITE 400
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City | BIRMINGHAM
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State | AL
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Zip | 35243-3377
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Country | US
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Telephone | 205-969-5887
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Fax | 205-969-5997
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Provider Business Mailing Address
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Address Line | 3411 COLONNADE PKWY SUITE 400
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City | BIRMINGHAM
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State | AL
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Zip | 35243-3377
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Country | US
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Telephone | 205-969-5887
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Fax | 205-969-5997
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | MR. VICTOR ALAN GILMORE
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Credential |
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Telephone | 205-969-5887
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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 | 09002256
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License Number State | AL
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