Organization
SAAGERS SHOE SHOP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NORMAN DEAN SAAGER (TRUSTEE)
(541) 938-5162
Entity
Organization
Contact information
Practice address
613 N MAIN ST, MILTON FREEWATER, OR 97862-1727
(541) 938-5162
(541) 938-3148
Mailing address
613 N MAIN ST, MILTON FREEWATER, OR 97862-1727
(541) 938-5162
(541) 938-3148
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
167767
—
OR
01
—
82828
LABOR & INDUSTRIES
WA
05
—
9021379
—
WA
Enumeration date
12/08/2006
Last updated
08/22/2020
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