Provider Demographics
NPI:1760516918
Name:NEWTON'S SHOES OF CLEMSON, INC.
Entity Type:Organization
Organization Name:NEWTON'S SHOES OF CLEMSON, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:A
Authorized Official - Last Name:NEWTON
Authorized Official - Suffix:
Authorized Official - Credentials:CERTIFIED PEDORTHIST
Authorized Official - Phone:864-654-3625
Mailing Address - Street 1:139 ANDERSON HWY
Mailing Address - Street 2:SUITE 110
Mailing Address - City:CLEMSON
Mailing Address - State:SC
Mailing Address - Zip Code:29631-1599
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:139 ANDERSON HWY
Practice Address - Street 2:SUITE 110
Practice Address - City:CLEMSON
Practice Address - State:SC
Practice Address - Zip Code:29631-1599
Practice Address - Country:US
Practice Address - Phone:864-654-3625
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-16
Last Update Date:2009-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC4337310001Medicare NSC