Provider Demographics
NPI:1508947375
Name:SHOE DOX, INC
Entity Type:Organization
Organization Name:SHOE DOX, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:WALTER
Authorized Official - Last Name:FOX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-288-4931
Mailing Address - Street 1:PO BOX 455
Mailing Address - Street 2:
Mailing Address - City:BLUE ISLAND
Mailing Address - State:IL
Mailing Address - Zip Code:60406-0455
Mailing Address - Country:US
Mailing Address - Phone:708-288-4931
Mailing Address - Fax:708-335-2294
Practice Address - Street 1:PARAGON MEDICAL BUILDING
Practice Address - Street 2:SUITE 304
Practice Address - City:ST. THOMAS
Practice Address - State:VI
Practice Address - Zip Code:00802
Practice Address - Country:US
Practice Address - Phone:340-344-4160
Practice Address - Fax:708-335-2294
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies