Provider Demographics
NPI:1801900162
Name:STERLING SHOES OF WARWICK,INC.
Entity type:Organization
Organization Name:STERLING SHOES OF WARWICK,INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRES.
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:D
Authorized Official - Last Name:PEARLMAN
Authorized Official - Suffix:
Authorized Official - Credentials:CERTIFIED PEDORTHIST
Authorized Official - Phone:401-691-3326
Mailing Address - Street 1:1730 POST RD
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02888-5941
Mailing Address - Country:US
Mailing Address - Phone:401-691-3326
Mailing Address - Fax:
Practice Address - Street 1:1730 POST RD
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02888-5941
Practice Address - Country:US
Practice Address - Phone:401-691-3326
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
RISS00107Medicaid
RI205217OtherBLUECHIP FOR MEDICARE
RI9550OtherBLUE CROSS OF R.I.
RI0129600001Medicare ID - Type Unspecified