DIABETIC SHOE SOURCE - NPI 1396168290 - Durable Medical Equipment & Medical Supplies in Vicksburg, MS

Q: What is Diabetic Shoe Source's NPI number?

The NPI number for Diabetic Shoe Source is 1396168290. It was assigned to this organization in the NPPES registry on January 28, 2014.

Q: What is Diabetic Shoe Source's specialty?

The primary specialty registered for this NPI is Durable Medical Equipment & Medical Supplies with taxonomy code 332B00000X.

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About Diabetic Shoe Source NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DIABETIC SHOE SOURCE (NPI 1396168290) is a healthcare organization registered as a durable medical equipment & medical supplies in Vicksburg, Mississippi and active in the NPI registry since January 2014. The organization lists James T Phelan, Owner, as its authorized official.

NPPES Registry Identity

NPI1396168290

Entity TypeOrganization

Primary Taxonomy332B00000X

Legal Business NameDIABETIC SHOE SOURCE

Location Address104 MCAULEY DRVicksburg, MS 39183-2825

Mailing Address104 Mcauley DrVicksburg, MS 39183-2825 · (601) 883-3342 · Fax (601) 856-5955

Phone(601) 883-3342

Fax(601) 856-5955

Organization SubpartNo

Authorized OfficialJames T PhelanOwner · (601) 506-5689

Enumeration DateJanuary 28, 2014

✔ NPI 1396168290 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDurable Medical Equipment & Medical SuppliesSuppliers

Taxonomy Code332B00000X

Definition

A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.

104 MCAULEY DR, Vicksburg, MS 39183

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Other Providers at the Same Location NPPES 10

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DANIEL P EDNEY MD

Internal Medicine