Provider Demographics
NPI:1902224827
Name:SOLE SUPPORTS, INC.
Entity Type:Organization
Organization Name:SOLE SUPPORTS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:SAMUEL
Authorized Official - Last Name:GLASER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:615-579-5846
Mailing Address - Street 1:7674 HWY 7
Mailing Address - Street 2:SOLE SUPPORTS, INC.
Mailing Address - City:LYLES
Mailing Address - State:TN
Mailing Address - Zip Code:37098-1571
Mailing Address - Country:US
Mailing Address - Phone:931-670-6111
Mailing Address - Fax:931-670-6008
Practice Address - Street 1:7674 HIGHWAY 7
Practice Address - Street 2:
Practice Address - City:LYLES
Practice Address - State:TN
Practice Address - Zip Code:37098-1571
Practice Address - Country:US
Practice Address - Phone:931-670-6111
Practice Address - Fax:931-670-6008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-29
Last Update Date:2014-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment