Provider Demographics
NPI:1851533772
Name:MEEKER MARSHALL SHOES
Entity Type:Organization
Organization Name:MEEKER MARSHALL SHOES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:
Authorized Official - Last Name:OLIGERI III
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-868-2918
Mailing Address - Street 1:220 MILLCREEK PLZ
Mailing Address - Street 2:2070 INTERCHANGE ROAD
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16565-1102
Mailing Address - Country:US
Mailing Address - Phone:814-868-2918
Mailing Address - Fax:814-866-9395
Practice Address - Street 1:220 MILLCREEK PLZ
Practice Address - Street 2:2070 INTERCHANGE ROAD
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16565-1102
Practice Address - Country:US
Practice Address - Phone:814-868-2918
Practice Address - Fax:814-866-9395
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-25
Last Update Date:2009-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA25276555332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA4705250001Medicare NSC