Organization Active NPI

Shoes Etc LLC

  • Durable Medical Equipment & Medical Supplies
  • Rock Hill, SC
National Provider Identifier
1508041872
Registry record updated Jun 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
046315575 Issued in SC
Legal business name
SHOES ETC LLC
Practice address
339 E Main Street
Suite 113
Rock Hill, SC 29730-5367
Phone
(803) 329-7463
Fax
(866) 843-2602
NPI assigned
Jan 7, 2008
Organization subpart
Yes
Parent organization
SHOES ETC LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 17, 2008

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

Authorized official

Name
Mr. William D McLeod
Title
Owner
Phone
(803) 730-3887

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 046315575 SC Primary

Addresses

Primary practice location

339 E Main Street
Suite 113
Rock Hill, SC 29730-5367

Mailing address

PO Box 2652
Irmo, SC 29063-4003
Phone (803) 781-5757

Other identifiers 1

IdentifierTypeStateIssuer
7704796MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Shoes Etc LLC2 organizations share this tax ID, including this one
Part of
Shoes Etc LLC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

339 E Main St
Ste 113
Rock Hill, SC 29730
Phone (803) 329-7463

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1199664000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213660800000",
    "number": "1508041872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2652",
            "city": "IRMO",
            "state": "SC",
            "postal_code": "290634003",
            "telephone_number": "803-781-5757",
            "fax_number": "866-843-2602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "339 E MAIN STREET",
            "address_2": "SUITE 113",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297305367",
            "telephone_number": "803-329-7463",
            "fax_number": "866-843-2602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHOES ETC LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SHOES ETC LLC",
        "enumeration_date": "2008-01-07",
        "last_updated": "2008-06-17",
        "status": "A",
        "authorized_official_last_name": "MCLEOD",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "803-730-3887",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "SC",
            "license": "046315575",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7704796",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rock Hill, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2008; 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.