Organization
FOOT SUPPORT SALES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM K MURRAY (OWNER)
(651) 779-0081
Entity
Organization
Contact information
Practice address
1845 COUNTY ROAD D E, MAPLEWOOD, MN 55109-5331
(651) 779-0081
(651) 779-0065
Mailing address
1845 COUNTY ROAD D E, MAPLEWOOD, MN 55109-5331
(651) 779-0081
(651) 779-0065
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
274R3FO
BCBS OF MN
MN
05
—
41753400
—
WI
Enumeration date
07/22/2006
Last updated
08/22/2020
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