Hagopian Shoes, LLC
Organization Active NPI Prosthetic/Orthotic Supplier · Wood River, IL
NPI 1760418099 · NPPES record last updated Jun 22, 2018
Key facts
- NPI
- 1760418099
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Prosthetic/Orthotic Supplier 335E00000X
- License
- 212000071 (IL)
- Legal business name
- HAGOPIAN SHOES, LLC
- Practice address
- 48 E Ferguson Ave
Wood River, IL 62095 - Phone
- (618) 254-0276
- Fax
- (618) 254-1233
- NPI assigned
- Jun 26, 2006
- Organization subpart
- No
Authorized official
- Name
- Mr. Andrew Hagopian, L.PED
- Title
- Owner
- Phone
- (618) 254-0276
National Provider Directory
Locations
48 E Ferguson Ave
Wood River, IL 62095
Phone (618) 254-0276
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prosthetic/Orthotic Supplier | 335E00000X | 212000071 | IL | Yes |
Addresses
Primary practice location
48 E Ferguson Ave
Wood River, IL 62095
Mailing address
48 E Ferguson Ave
Wood River, IL 62095
Phone (618) 254-0276
Other names
- Cleary's Shoes & Boots
Other providers in Wood River, IL
- William M Goebel
- Frederic Golden
- Belinda Gunning
- Shea Whitney Guss
- Kristine Lynn Hagen
- Bailey Hardy
- Kevin L Hendrick
- Dawn Marie Hicks
- Highland Park CVS, L.L.C.
- Christopher Hurtte
All providers in Wood River, IL · Prosthetic/Orthotic Supplier in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 22, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.