Organization
ULTIMATE FOOT STORE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID R GRIFFITH (VP/TREASURER)
(808) 542-0736
Entity
Organization
Contact information
Practice address
820 W HIND DR STE 103, HONOLULU, HI 96821-1849
(808) 542-0736
(808) 440-5251
Mailing address
707 RICHARDS ST STE 525, HONOLULU, HI 96813-4623
(808) 542-0736
(808) 440-5251
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
GE-115-516-2112-01
GENERAL EXCISE TAX LICENSE
HI
Enumeration date
10/19/2018
Last updated
09/09/2019
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