Provider Demographics
NPI:1164581492
Name:ZELCO, INC
Entity Type:Organization
Organization Name:ZELCO, INC
Other - Org Name:FOOT SOLUTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:A
Authorized Official - Last Name:ZELIN
Authorized Official - Suffix:
Authorized Official - Credentials:CPED
Authorized Official - Phone:704-540-4664
Mailing Address - Street 1:16131 LANCASTER HIGHWAY
Mailing Address - Street 2:STE 3
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28277
Mailing Address - Country:US
Mailing Address - Phone:704-540-4664
Mailing Address - Fax:
Practice Address - Street 1:16131 LANCASTER HIGHWAY
Practice Address - Street 2:STE 3
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28277-2033
Practice Address - Country:US
Practice Address - Phone:704-540-4664
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-06
Last Update Date:2013-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC332BC3200X
335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7705134Medicaid
NC5821150001Medicare NSC