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Organization

FOOT HEALTH CENTER, LLC

Active
Other names
Medicare NSC
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MICHAEL J ACKLEY DPM (PODIATRIST, OWNER)
(203) 271-0556
Entity
Organization

Contact information

Practice address
714 S MAIN ST, CHESHIRE, CT 06410-3448
(203) 271-0556
(203) 250-9951
Mailing address
714 S MAIN ST, CHESHIRE, CT 06410-3448
(203) 271-0556
(203) 250-9951

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
395
CT
332B00000X
Durable Medical Equipment & Medical Supplies
395
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
030000395CT01
ANTHEM BCBS
CT
01
0542290
CIGNA
CT
01
129286
FIRST CHOICE PREF ONE
CT
01
2721297
AETNA
CT
01
2V1300
HEALTHNET
CT
05
4068714
CT
01
480028957
MEDICARE RAILROAD
CT
01
787023
CONNECTICARE
CT
01
NHS221
OXFORD HEALTH PLAN
CT
Enumeration date
10/12/2006
Last updated
11/14/2011
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