Provider Demographics
NPI:1326069477
Name:HEALTHY FEET INC
Entity Type:Organization
Organization Name:HEALTHY FEET INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:E
Authorized Official - Last Name:COLEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-463-1007
Mailing Address - Street 1:3500 VIRGINIA BEACH BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-4445
Mailing Address - Country:US
Mailing Address - Phone:757-463-1007
Mailing Address - Fax:757-463-2998
Practice Address - Street 1:3500 VIRGINIA BEACH BLVD STE 100
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-4445
Practice Address - Country:US
Practice Address - Phone:757-463-1007
Practice Address - Fax:757-463-2998
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA172263OtherBCBS OF VA
VA=========OtherTAX ID NUMBER
VA=========OtherTAX ID NUMBER