Provider Demographics
NPI:1679821706
Name:HESTER'S SPECIALTY SHOES AND ORTHOTICS
Entity Type:Organization
Organization Name:HESTER'S SPECIALTY SHOES AND ORTHOTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PEGGY
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:LANIER-HESTER
Authorized Official - Suffix:
Authorized Official - Credentials:C-PED, RN
Authorized Official - Phone:561-805-9500
Mailing Address - Street 1:1000 STINSON WAY
Mailing Address - Street 2:SUITE 102
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-3733
Mailing Address - Country:US
Mailing Address - Phone:561-805-9500
Mailing Address - Fax:561-805-9807
Practice Address - Street 1:1000 STINSON WAY
Practice Address - Street 2:SUITE 102
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-3733
Practice Address - Country:US
Practice Address - Phone:561-805-9500
Practice Address - Fax:561-805-9807
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-21
Last Update Date:2012-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies