Provider Demographics
NPI:1346376381
Name:FOOT SOLUTIONS PHX INC
Entity Type:Organization
Organization Name:FOOT SOLUTIONS PHX INC
Other - Org Name:FOOT SOLUTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:ODELL
Authorized Official - Last Name:BOEHNING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-298-1822
Mailing Address - Street 1:2340 W BELL RD STE 112
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85023-3206
Mailing Address - Country:US
Mailing Address - Phone:602-298-1822
Mailing Address - Fax:602-298-1823
Practice Address - Street 1:2340 W BELL RD STE 112
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85023-3206
Practice Address - Country:US
Practice Address - Phone:602-298-1822
Practice Address - Fax:602-298-1823
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-26
Last Update Date:2008-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ4153650001Medicare NSC