Organization
UNGERS SHOE STORE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSEPH E UNGER C PEO (OWNER PRESIDENT)
(740) 532-5954
Entity
Organization
Contact information
Practice address
304 S 3RD ST, IRONTON, OH 45638-1629
(740) 532-5954
(740) 532-4507
Mailing address
304 S 3RD ST, IRONTON, OH 45638-1629
(740) 532-5954
(740) 532-4507
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0243810
—
OH
01
—
90272261
MEDICAID
KY
Enumeration date
12/12/2006
Last updated
08/22/2020
Update your record
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