Provider Demographics
NPI:1316011877
Name:B&S SHOES & ORTHOTICS
Entity Type:Organization
Organization Name:B&S SHOES & ORTHOTICS
Other - Org Name:B&S SHOES & ORTHOTICS INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:V PRES
Authorized Official - Prefix:MR
Authorized Official - First Name:ABE
Authorized Official - Middle Name:H
Authorized Official - Last Name:SALZMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-878-5077
Mailing Address - Street 1:5938 LANSDOWNE AVE
Mailing Address - Street 2:
Mailing Address - City:PHILA
Mailing Address - State:PA
Mailing Address - Zip Code:19151
Mailing Address - Country:US
Mailing Address - Phone:215-878-5077
Mailing Address - Fax:215-473-1446
Practice Address - Street 1:5938 LANSDOWNE AVE
Practice Address - Street 2:
Practice Address - City:PHILA
Practice Address - State:PA
Practice Address - Zip Code:19151
Practice Address - Country:US
Practice Address - Phone:215-878-5077
Practice Address - Fax:215-473-1446
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-17
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
PA0008235460002Medicaid
PA0008235460002Medicaid