Provider Demographics
NPI:1578708590
Name:GOOD FEET - BIRMINGHAM, LLC
Entity Type:Organization
Organization Name:GOOD FEET - BIRMINGHAM, LLC
Other - Org Name:GOOD FEET
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:GILMORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-969-5887
Mailing Address - Street 1:3411 COLONNADE PKWY
Mailing Address - Street 2:SUITE 400
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35243-3377
Mailing Address - Country:US
Mailing Address - Phone:205-969-5887
Mailing Address - Fax:205-969-5997
Practice Address - Street 1:3411 COLONNADE PKWY
Practice Address - Street 2:SUITE 400
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35243-3377
Practice Address - Country:US
Practice Address - Phone:205-969-5887
Practice Address - Fax:205-969-5997
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-04
Last Update Date:2008-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL09002256332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies