Provider Demographics
NPI:1013290212
Name:WINCHESTER FAMILY FOOT CARE
Entity Type:Organization
Organization Name:WINCHESTER FAMILY FOOT CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CERTIFIED PEDORTHIST
Authorized Official - Prefix:MS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:L
Authorized Official - Last Name:PARVIN
Authorized Official - Suffix:
Authorized Official - Credentials:CPED
Authorized Official - Phone:256-658-1177
Mailing Address - Street 1:1961 WINCHESTER RD NE
Mailing Address - Street 2:STE. K
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35811-7100
Mailing Address - Country:US
Mailing Address - Phone:256-658-1177
Mailing Address - Fax:256-859-0066
Practice Address - Street 1:1961 WINCHESTER RD NE
Practice Address - Street 2:STE. K
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35811-7100
Practice Address - Country:US
Practice Address - Phone:256-658-1177
Practice Address - Fax:256-859-0066
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-23
Last Update Date:2011-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies