Organization
RLSM, LLC
Active
Other names
Fair's Shoe Store
Organization subpart
No
Provider details
NPI number
Authorized official
CYNTHIA WARREN (MANAGING MEMBER)
(316) 682-1821
Entity
Organization
Contact information
Practice address
2407 W 13TH ST N, WICHITA, KS 67203-1930
(316) 943-1791
(316) 943-0347
Mailing address
4723 E DOUGLAS AVE, WICHITA, KS 67218-1012
(316) 682-1821
(316) 682-1005
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
335E00000X
Prosthetic/Orthotic Supplier
—
—
Other
Enumeration date
09/11/2008
Last updated
01/14/2009
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