Ballows Shoes Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

BALLOWS SHOES INC

Practice address

308 Mill Street
Bristol, PA 19007-4811

Phone

(215) 788-2857

Fax

(215) 788-2857

NPI assigned

Apr 18, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Neil Jeffrey Gervon

Title

Manager

Phone

(215) 788-2857

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Ballows Shoes Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1356567234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 MILL STREET",
            "city": "BRISTOL",
            "state": "PA",
            "postal_code": "190074811",
            "telephone_number": "215-788-2857",
            "fax_number": "215-788-2857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 MILL STREET",
            "city": "BRISTOL",
            "state": "PA",
            "postal_code": "190074811",
            "telephone_number": "215-788-2857",
            "fax_number": "215-788-2857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BALLOWS SHOES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GERVON",
        "authorized_official_first_name": "NEIL",
        "authorized_official_middle_name": "JEFFREY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "215-788-2857",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6000000704",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ballows Shoes",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Durable Medical Equipment & Medical Supplies in Bristol, PA
• Providers in Bristol, PA by specialty
• Durable Medical Equipment & Medical Supplies in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.