Organization
MONROE'S FAMILY SHOE CENTER INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HERBERT BROOKS HUMPHRIES JR. CERTIFIED PEDORTHIST (PRESIDENT)
(704) 283-5814
Entity
Organization
Contact information
Practice address
1800 DICKERSON BLVD, MONROE, NC 28110-2758
(704) 283-5814
(704) 289-6767
Mailing address
PO BOX 1216, MONROE, NC 28111-1216
(704) 283-5814
(704) 289-6767
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0427X
BCBS PROVIDER NUMBER
NC
05
—
7702016
—
NC
05
—
DE1074
—
SC
Enumeration date
01/29/2007
Last updated
01/06/2009
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