Organization
SHIRLEY'S SHOE SHOPPE INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL SCHEINBERG C.PED O.S.T. (PRESIDENT)
(814) 941-7424
Entity
Organization
Contact information
Practice address
1400 11TH AVE, ALTOONA, PA 16601-3304
(814) 941-7424
(814) 941-2118
Mailing address
PO BOX 2006, ALTOONA, PA 16603-2006
(814) 941-7424
(814) 941-2118
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
6000006405
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6000006405
DRUG AND DEVICE PA DEPT
PA
Enumeration date
01/03/2007
Last updated
10/23/2009
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