Provider Demographics
NPI:1407086887
Name:SAS COMFORT SHOES OF SANTA BARBARA
Entity Type:Organization
Organization Name:SAS COMFORT SHOES OF SANTA BARBARA
Other - Org Name:SAS COMFORT SHOES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER/PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:WARREN
Authorized Official - Last Name:HARTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-845-3898
Mailing Address - Street 1:3423 STATE ST.
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93105
Mailing Address - Country:US
Mailing Address - Phone:805-845-3898
Mailing Address - Fax:
Practice Address - Street 1:3423 STATE ST
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93105-2625
Practice Address - Country:US
Practice Address - Phone:805-845-2698
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-21
Last Update Date:2009-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site