Provider Demographics
NPI:1649309584
Name:FLEMING'S COMFORT FOOTWEAR, INC.
Entity type:Organization
Organization Name:FLEMING'S COMFORT FOOTWEAR, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:MARTIN
Authorized Official - Last Name:FLEMING
Authorized Official - Suffix:
Authorized Official - Credentials:LPED
Authorized Official - Phone:918-743-7463
Mailing Address - Street 1:5914 S LEWIS AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74105-7112
Mailing Address - Country:US
Mailing Address - Phone:918-743-7463
Mailing Address - Fax:
Practice Address - Street 1:5914 S LEWIS AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74105-7112
Practice Address - Country:US
Practice Address - Phone:918-743-7463
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK11332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies