Provider Demographics
NPI:1619196268
Name:HAMILTON SMITH INC.
Entity Type:Organization
Organization Name:HAMILTON SMITH INC.
Other - Org Name:THE FEET PEOPLE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARY JO
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:HAMILTON
Authorized Official - Suffix:
Authorized Official - Credentials:CPED
Authorized Official - Phone:218-822-3026
Mailing Address - Street 1:7837 EXCELSIOR RD
Mailing Address - Street 2:
Mailing Address - City:BAXTER
Mailing Address - State:MN
Mailing Address - Zip Code:56425-8427
Mailing Address - Country:US
Mailing Address - Phone:218-822-3026
Mailing Address - Fax:218-829-8554
Practice Address - Street 1:7837 EXCELSIOR RD
Practice Address - Street 2:
Practice Address - City:BAXTER
Practice Address - State:MN
Practice Address - Zip Code:56425-8427
Practice Address - Country:US
Practice Address - Phone:218-822-3026
Practice Address - Fax:218-829-8554
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-24
Last Update Date:2008-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN748115000Medicaid
MN6027460001Medicare NSC