2ND SOLE-CUSTOM SHOES & ORTHOTICS, INC; NPI #1841321403

Contact Information

2ND SOLE-CUSTOM SHOES & ORTHOTICS, INC

5923 CLARK RD
SUITE C
PARADISE, CA 95969-4866

Phone: 530-872-3710
Fax: 530-872-7234
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Customized Equipment	332BC3200X	87	All Other Suppliers

Indicates primary specialty

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NPI Profile & details for 2ND SOLE-CUSTOM SHOES & ORTHOTICS, INC

NPI #	`1841321403`
LBN Legal business name	2ND SOLE-CUSTOM SHOES & ORTHOTICS, INC
Authorized official	BRADY ELLIOTT - (VICE-PRESIDENT)
Entity	Organization
Organization subpart ¹	No
Enumeration date	03/08/2007
Last updated	01/05/2015 - About 11 years ago
Identifiers	n/a

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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