PROVOST SHOES NPI 1972743268

NPI Information

  • NPI: 1972743268
  • Provider Name: PROVOST SHOES
  • Classification: Durable Medical Equipment & Medical Supplies - 332B00000X
  • Entity Type: Organization
  • Address: 225 COLUMBIA MALL DR
    BLOOMSBURG, PA
    ZIP 17815
  • Phone: (570) 784-4645

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NPI Details

PROVOST SHOES is a durable medical equipment medical supplies in Bloomsburg, PA. 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. PROVOST SHOES NPI is 1972743268. The provider is registered as an organization entity type.

The provider's business location address is:

225 COLUMBIA MALL DR
BLOOMSBURG, PA
ZIP 17815-368
Phone: (570) 784-4645
Fax: (570) 455-7704

The provider's authorized official is John Marshall Provost .
The authorized official title is Owner and has the following contact phone number (570) 784-4645.

The enumeration date for this NPI number is 2/25/2009 and was last updated on 2/25/2009.

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:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1332B00000XDurable Medical Equipment & Medical Supplies4244780001PENNSYLVANIAYes

Other Identifiers

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

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
14244780001MEDICARE NSC

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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