Provider Demographics
NPI:1093826232
Name:FOOTFIT, INC
Entity Type:Organization
Organization Name:FOOTFIT, INC
Other - Org Name:FOOT SOLUTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JUDY
Authorized Official - Middle Name:
Authorized Official - Last Name:FREYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-846-3434
Mailing Address - Street 1:924 PARK CENTER DRIVE STE 101
Mailing Address - Street 2:
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28105
Mailing Address - Country:US
Mailing Address - Phone:704-846-3434
Mailing Address - Fax:704-846-3667
Practice Address - Street 1:924 PARK CENTER DR STE 101
Practice Address - Street 2:
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28105-5032
Practice Address - Country:US
Practice Address - Phone:704-846-3434
Practice Address - Fax:704-846-3667
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2011-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC045PPOtherBC/BS
4282100001Medicare ID - Type Unspecified