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General NPI Number Information
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NPI Number | 1922544659
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Entity Type | Organization
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Legal Business Name | THE SHOE BOX
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Dates
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Enumeration Date | 01/19/2017
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Last Update Date | 01/19/2017
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Provider Practice Location Address
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Address Line | 2820 S MONROE ST
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City | TALLAHASSEE
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State | FL
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Zip | 32301-6952
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Country | US
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Telephone | 850-877-9174
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Fax | 850-877-9203
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Provider Business Mailing Address
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Address Line | 2820 S MONROE ST
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City | TALLAHASSEE
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State | FL
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Zip | 32301-6952
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Country | US
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Telephone | 850-877-9174
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Fax | 850-877-9203
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Authorized Official
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Title or Position | OWNER
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Name | WILLIAM WELDON
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Credential |
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Telephone | 850-877-9174
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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 | 4780120174684
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License Number State | FL
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