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Organization
SCARFO ATHLETIC SHOE CO INC
Active
Organization
SCARFO ATHLETIC SHOE CO INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIA R SCARFO (TREASURER)
(978) 663-4346
Entity
Organization
Contact information
Practice address
787 BOSTON RD, BILLERICA, MA 01821
(978) 663-4346
Mailing address
787 BOSTON RD, BILLERICA, MA 01821
(978) 663-4346
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0819470001
PROVIDER NUMBER
—
Enumeration date
02/01/2008
Last updated
04/01/2008
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