MODERN SHOE INC. NPI 1225219587

NPI Information

MODERN SHOE, INC. is a durable medical equipment medical supplies in Provo, UT. 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. MODERN SHOE, INC. NPI is 1225219587. The provider is registered as an organization entity type.

The provider's business location address is:

350 W CENTER ST
PROVO, UT
ZIP 84601-323
Phone: (801) 375-2711
Fax: (801) 371-0060

The provider's authorized official is Anthony C Thomas .
The authorized official title is President and has the following contact phone number (801) 375-2711.

The enumeration date for this NPI number is 11/15/2007 and was last updated on 5/28/2010.

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

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