Provider Demographics
NPI:1245784420
Name:LACES OR VELCRO CORP.
Entity Type:Organization
Organization Name:LACES OR VELCRO CORP.
Other - Org Name:HEAD TO TOE MEDICAL SUPPLIES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:FELIX
Authorized Official - Middle Name:
Authorized Official - Last Name:CALDERON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-410-4014
Mailing Address - Street 1:1007A OGDEN AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10452-5104
Mailing Address - Country:US
Mailing Address - Phone:917-471-8833
Mailing Address - Fax:917-471-8834
Practice Address - Street 1:1007A OGDEN AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10452-5104
Practice Address - Country:US
Practice Address - Phone:917-471-8833
Practice Address - Fax:917-471-8834
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-05
Last Update Date:2016-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2041368-DCA332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment