Organization
STAR SHOES CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JANICE L. ROGERS (SECRETARY TREASURER)
(678) 225-4569
Entity
Organization
Contact information
Practice address
3370 SUGARLOAF PARKWAY, SUITE G-6, LAWRENCEVILLE, GA 30044-5478
(678) 225-4569
(678) 225-5749
Mailing address
3370 SUGARLOAF PKWY, SUITE G-6, LAWRENCEVILLE, GA 30044-5478
(678) 225-4569
(678) 225-5749
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Enumeration date
05/14/2007
Last updated
08/18/2009
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