Provider Demographics
NPI:1144418476
Name:FOOTCARE EXPRESS INC
Entity Type:Organization
Organization Name:FOOTCARE EXPRESS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:JARETT
Authorized Official - Middle Name:
Authorized Official - Last Name:REINHARTZ
Authorized Official - Suffix:
Authorized Official - Credentials:C PED
Authorized Official - Phone:305-932-0922
Mailing Address - Street 1:18280 W DIXIE HWY
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33160-2001
Mailing Address - Country:US
Mailing Address - Phone:305-932-0922
Mailing Address - Fax:305-932-0923
Practice Address - Street 1:18280 W DIXIE HWY
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33160-2001
Practice Address - Country:US
Practice Address - Phone:305-932-0922
Practice Address - Fax:305-932-0923
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-11
Last Update Date:2010-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1157430001Medicare NSC