PACIFIC FOOTWEAR COMPANY, INC.; NPI #1841581717

Contact Information

PACIFIC FOOTWEAR COMPANY, INC.

955 TOWN CENTRE DR STE A
MEDFORD, OR 97504-6188

Phone: 547-608-7400
Fax: 541-608-7600
Website:

Specialty	Taxonomy Code	Specialty Code	Provider Type
Customized Equipment	332BC3200X	87	All Other Suppliers
Prosthetic/Orthotic Supplier	335E00000X	51	Medical Supply Company with Orthotist

Indicates primary specialty

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NPI Profile & details for PACIFIC FOOTWEAR COMPANY, INC.

NPI # 1841581717

LBN Legal business name PACIFIC FOOTWEAR COMPANY, INC.

Authorized official KEVIN CLARKE - (PRESIDENT)

Entity Organization

Organization subpart ¹ No

Enumeration date 04/27/2011

Last updated 04/22/2025 - More than a year ago

Identifiers

Medicaid

297988

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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PACIFIC FOOTWEAR COMPANY, INC.

Contact Information

Specialty

Customized Equipment

Prosthetic/Orthotic Supplier

NPI Profile & details for PACIFIC FOOTWEAR COMPANY, INC.

Reviews for PACIFIC FOOTWEAR COMPANY, INC.