MEDICARE: HOUSE OF SHOES OF DARTMOUTH INC.

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
1	332B00000X	Durable Medical Equipment & Medical Supplies

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1871636225
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOUSE OF SHOES OF DARTMOUTH INC.

Provider Business Mailing Address
First Line	:	98 STATE RD
Second Line	:
City	:	NORTH DARTMOUTH
State	:	MA
Zip	:	02747-2921
Country	:	US
Telephone Number	:	508-997-7215
Fax Number	:	508-999-0236

Provider Business Practice Location Address
First Line	:	98 STATE RD
Second Line	:
City	:	NORTH DARTMOUTH
State	:	MA
Zip	:	02747-2921
Country	:	US
Telephone Number	:	508-997-7215
Fax Number	:	508-999-0236

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. MICHAEL FRIEDLAND
Credential	:	CERTIFIED PEDORTHIST
Telephone Number	:	508-997-7215

Provider Enumeration Date	:	02/15/2007
Last Update Date	:	08/22/2020

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Directions to “HOUSE OF SHOES OF DARTMOUTH INC. ” Practice Location

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