LAKE CITY SHOE REPAIR NPI 1346629029

NPI Information

LAKE CITY SHOE REPAIR is a durable medical equipment medical supplies in Coeur D Alene, ID. The provider is 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. LAKE CITY SHOE REPAIR NPI is 1346629029. The provider is registered as an organization entity type.
The provider Other Name Is Partnership.

The provider's business location address is:

3115 N GOVERNMENT WAY
#7
COEUR D ALENE, ID
ZIP 83815-790
Phone: (208) 762-0797
Fax: (208) 762-0791

The provider's authorized official is Wayne C Johnson .
The authorized official title is Senior Partnor and has the following contact phone number (208) 762-0797.

The enumeration date for this NPI number is 5/27/2015 and was last updated on 11/12/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.