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NPI Code Detail

MEDICARE: SAFETY PLUS FOOTWEAR CENTER, LLC

MEDICARE: SAFETY PLUS FOOTWEAR CENTER, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1332B00000XDurable Medical Equipment & Medical Supplies

General Provider Information

NPI Number : 1861672925
Entity Type Code : Organization
Provider Name (Legal Business Name) : SAFETY PLUS FOOTWEAR CENTER, LLC
Provider Business Mailing Address
First Line : 7534 GRANBY ST
Second Line :
City : NORFOLK
State : VA
Zip : 23505-3427
Country : US
Telephone Number : 757-588-2335
Fax Number : 757-588-2241
Provider Business Practice Location Address
First Line : 7534 GRANBY ST
Second Line :
City : NORFOLK
State : VA
Zip : 23505-3427
Country : US
Telephone Number : 757-588-2335
Fax Number : 757-588-2241
Authorized Official
Title or Position : MANAGING OWNER
Name : YOLANDA C MEBANE
Credential :
Telephone Number : 757-588-2335
Provider Enumeration Date : 11/06/2007
Last Update Date : 05/28/2008

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Directions to “SAFETY PLUS FOOTWEAR CENTER, LLC ” Practice Location

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