PROVOST SHOES
NPI 1447431945
Durable Medical Equipment & Medical Supplies in Hazleton, PA

Active since November 26, 2007
25 LAUREL MALL, HAZLETON, PA 18202(570) 455-7704(570) 455-7704 Get Directions Write a Review

NPPES record last updated: December 5, 2007. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Provost Shoes NPPES

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

PROVOST SHOES (NPI 1447431945) is a healthcare organization registered as a durable medical equipment & medical supplies in Hazleton, Pennsylvania and active in the NPI registry since November 2007. The organization lists John M Provost, Owner, as its authorized official.

NPPES Registry Identity

NPI1447431945
Entity TypeOrganization
Primary Taxonomy332B00000X
Legal Business NamePROVOST SHOES
Location Address25 LAUREL MALLHazleton, PA 18202-1201
Mailing Address25 Laurel MallHazleton, PA 18202-1201 · (570) 455-7704 · Fax (570) 455-7704
Fax(570) 455-7704
Organization SubpartNo
Authorized OfficialJohn M ProvostOwner · (570) 455-7704
Enumeration DateNovember 26, 2007
Last NPPES UpdateDecember 5, 2007
NPI 1447431945 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDurable Medical Equipment & Medical SuppliesSuppliers
Taxonomy Code332B00000X
License Licensed in PA · 4244780002
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.

25 LAUREL MALL, Hazleton, PA 18202

Other Identifiers 2

Medicare NSC4244780002PA
OtherA08009797Medicare Edi Billing Numb

Medical Equipment Supplier

The provider carries the following medical supplies product categories:

PTAN
20553071
Accepts Medicare Assignment
NO
Specialities List
MSC With Orthotic Personnel, Orthotic Personnel.
Provider Type List
PEDORTHIC PERSONNEL.
Competitive Bidding
NO

Supplies List

  • Orthoses: Custom Fabricated - Custom met pads, Custom heel pads, Custom heel spur pads
  • Orthoses: Prefabricated (Non-Custom Fabricated) - Met pads, Heel pads, Heel spur pads
  • Orthoses: Off-The-Shelf - Met pads, Heel pads, Heel spur pads
  • Limb Prostheses - Prosthetic arms, Prosthetic feet, Prosthetic knees
  • Diabetic Shoes and Inserts - Shoes, Socks, Insoles
  • Diabetic Shoes/Inserts - Custom - Custom fabricated shoes, socks, & insoles
  • Lymphedema Compression Treatment Items -

Other Providers at the Same Location NPPES

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

Durable Medical Equipment & Medical Supplies
25 LAUREL MALL, PROVOST SHOES
HAZLETON, PA 18202

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1447431945, enumerated as an "organization" on November 26, 2007.

The provider is located at 25 LAUREL MALL HAZLETON, PA 18202 and the phone number is (570) 455-7704.

Durable Medical Equipment & Medical Supplies with taxonomy code 332B00000X.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.