Provider Demographics
NPI:1013028257
Name:FS ARIZONA THREE
Entity Type:Organization
Organization Name:FS ARIZONA THREE
Other - Org Name:FOOT SOLUTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:BARKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:623-584-1618
Mailing Address - Street 1:13980 W BELL RD STE 7
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85374-3800
Mailing Address - Country:US
Mailing Address - Phone:623-584-1618
Mailing Address - Fax:623-584-1627
Practice Address - Street 1:13980 W BELL RD STE 7
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85374-3800
Practice Address - Country:US
Practice Address - Phone:623-584-1618
Practice Address - Fax:623-584-1627
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ=========OtherBC/BS
AZ5195700001Medicare ID - Type Unspecified