Carl'S Footwear

Key facts

NPI

1386792802

Entity type

Organization (NPI type 2)

Primary specialty

Durable Medical Equipment & Medical Supplies 332B00000X

License

71006602 (IA)

Legal business name

CARL'S FOOTWEAR

Practice address

319 9TH St
Sheldon, IA 51201-1556

Phone

(712) 324-2623

NPI assigned

Jan 8, 2007

Organization subpart

No

Authorized official

Name

Joel Bousema

Title

President

Phone

(712) 324-2623

National Provider Directory

Locations

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Nov 19, 2007.

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1195430400000",
    "number": "1386792802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "319 9TH ST",
            "city": "SHELDON",
            "state": "IA",
            "postal_code": "512011556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "319 9TH ST",
            "city": "SHELDON",
            "state": "IA",
            "postal_code": "512011556",
            "telephone_number": "712-324-2623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARL'S FOOTWEAR",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-08",
        "last_updated": "2007-11-19",
        "status": "A",
        "authorized_official_last_name": "BOUSEMA",
        "authorized_official_first_name": "JOEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "712-324-2623"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "IA",
            "license": "71006602",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Sheldon, IA · Durable Medical Equipment & Medical Supplies in Iowa