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PROVOST SHOES
NPI 1972743268
Durable Medical Equipment & Medical Supplies in Bloomsburg, PA

Active since February 25, 2009
225 COLUMBIA MALL DR, BLOOMSBURG, PA 17815(570) 784-4645(570) 455-7704 Get Directions Write a Review

NPPES record last updated: February 25, 2009. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Provost Shoes NPPES

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

PROVOST SHOES (NPI 1972743268) is a healthcare organization registered as a durable medical equipment & medical supplies in Bloomsburg, Pennsylvania and active in the NPI registry since February 2009. The organization lists John Marshall Provost, Owner, as its authorized official.

NPPES Registry Identity

NPI1972743268
Entity TypeOrganization
Primary Taxonomy332B00000X
Legal Business NamePROVOST SHOES
Location Address225 COLUMBIA MALL DRBloomsburg, PA 17815-8368
Mailing Address225 Columbia Mall DrBloomsburg, PA 17815-8368 · (570) 784-4645 · Fax (570) 455-7704
Phone(570) 784-4645
Fax(570) 455-7704
Organization SubpartNo
Authorized OfficialJohn Marshall ProvostOwner · (570) 784-4645
Enumeration DateFebruary 25, 2009
✔ NPI 1972743268 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 · 4244780001
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.
225 COLUMBIA MALL DR, Bloomsburg, PA 17815
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Other Identifiers 1

Medicare NSC4244780001

Other Providers at the Same Location NPPES 2

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

LUXOTTICA RETAIL NORTH AMERICA INC
Eyewear Supplier
225 COLUMBIA MALL DR
BLOOMSBURG, PA 17815
Columbia County (570) 387-1340
WILKES BARRE VAMC
Clinic/Center (VA)
225 COLUMBIA MALL DR
BLOOMSBURG, PA 17815
Columbia County (717) 277-6565

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Provost Shoes's NPI number?

The NPI number for Provost Shoes is 1972743268. It was assigned to this organization in the NPPES registry on February 25, 2009.

Where is Provost Shoes located?

Provost Shoes is located at 225 Columbia Mall Dr, Bloomsburg, PA 17815. The listed phone number is (570) 784-4645.

What is Provost Shoes's specialty?

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

When was this NPI record last updated?

The NPPES record for Provost Shoes was last updated on February 25, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.