Organization
MERRITTS DIABETIC SHOES AND MORE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CURTIS MERRITT (PRESIDENT)
(270) 200-2100
Entity
Organization
Contact information
Practice address
722 W MAIN ST, CLARKSON, KY 42726-7048
(270) 200-2100
(270) 200-2101
Mailing address
722 W MAIN ST, P O BOX 258, CLARKSON, KY 42726-7048
(270) 200-2100
(270) 200-2101
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2862816000
PASSPORT ADVANTAGE
KY
01
—
50016031
PASSPORT HEALTHPLAN
KY
05
—
7100004020
—
KY
Enumeration date
11/05/2007
Last updated
11/05/2007
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