Provider Demographics
NPI:1598975906
Name:HALL'S COMFORT SHOES & REPAIR
Entity Type:Organization
Organization Name:HALL'S COMFORT SHOES & REPAIR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ORIEN
Authorized Official - Middle Name:F
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:CERTIFIED PEDORTHIST
Authorized Official - Phone:813-960-9437
Mailing Address - Street 1:13540 N FLORIDA AVE STE 106
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33613-3209
Mailing Address - Country:US
Mailing Address - Phone:813-960-9437
Mailing Address - Fax:813-960-9437
Practice Address - Street 1:13540 N FLORIDA AVE STE 106
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33613-3209
Practice Address - Country:US
Practice Address - Phone:813-960-9437
Practice Address - Fax:813-960-9437
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies