Provider Demographics
NPI:1932518156
Name:ALEX'S COMFORT SHOES INC
Entity Type:Organization
Organization Name:ALEX'S COMFORT SHOES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:D
Authorized Official - Last Name:RUDAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-967-5858
Mailing Address - Street 1:5333 SUNRISE BLVD
Mailing Address - Street 2:
Mailing Address - City:FAIR OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:95628-3539
Mailing Address - Country:US
Mailing Address - Phone:916-967-5858
Mailing Address - Fax:916-967-1009
Practice Address - Street 1:5333 SUNRISE BLVD
Practice Address - Street 2:
Practice Address - City:FAIR OAKS
Practice Address - State:CA
Practice Address - Zip Code:95628-3539
Practice Address - Country:US
Practice Address - Phone:916-967-5858
Practice Address - Fax:916-967-1009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-13
Last Update Date:2014-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier