Provider Demographics
NPI:1700860442
Name:THE HEALTHY FOOT LLC
Entity Type:Organization
Organization Name:THE HEALTHY FOOT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:STEPHEN
Authorized Official - Last Name:CALL
Authorized Official - Suffix:JR
Authorized Official - Credentials:CPED
Authorized Official - Phone:540-725-7740
Mailing Address - Street 1:2010 ELECTRIC RD SW
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24018
Mailing Address - Country:US
Mailing Address - Phone:540-725-7740
Mailing Address - Fax:540-725-7741
Practice Address - Street 1:2010 ELECTRIC RD SW
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24018
Practice Address - Country:US
Practice Address - Phone:540-725-7740
Practice Address - Fax:540-725-7741
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA436425OtherANTHEM
VA9120548Medicaid
VA4186690001Medicare ID - Type Unspecified