# PARK SHOES INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Village Bootery
- **Organization subpart:** No

## Provider details

- **NPI number:** 1477720894
- **Authorized official:** MRS. TERESA ANN O'BRIEN (SALES/BILLING)
- **Authorized official phone:** (772) 283-3833

## Contact information

- **Practice address:** 2641 SE OCEAN BLVD, STUART, FL 34996-3401
- **Practice address phone:** (772) 746-3536
- **Practice address fax:** (772) 744-7851
- **Mailing address:** 2641 SE OCEAN BLVD, STUART, FL 34996-3401
- **Mailing address phone:** (772) 746-3536
- **Mailing address fax:** (772) 744-7851

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | 5114170001 | FL | Yes |

## Other

- **Enumeration date:** 05/14/2008
- **Last updated:** 05/14/2008