Organization
CHARLIES FOOTCARE & MEDICAL SUPPLY INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JUDITH JACQUELYN BOND ABC/CO/BOCO/LO-FL. (OWNER)
(615) 848-1381
Entity
Organization
Contact information
Practice address
416 MEDICAL CENTER PKWY STE C, MURFREESBORO, TN 37129-2753
(615) 848-1381
(615) 848-0717
Mailing address
416 MEDICAL CENTER PKWY STE C, MURFREESBORO, TN 37129-2753
(615) 848-1381
(615) 848-0717
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1452383
—
TN
01
—
4080266
BLUE CROSS BLUE SHEILD
TN
Enumeration date
11/01/2006
Last updated
12/22/2008
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