MODERN SHOE, INC. (NPI# 1225219587) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225219587 |
| Entity Type | Organization |
| Organization Name | MODERN SHOE, INC. |
| Practice Address |
350 W Center St Provo UT 84601-4323 |
| Practice Telephone | 8013752711 |
| Practice Fax Number | 8013710060 |
| Mailing Telephone | 8013752711 |
| Mailing Fax Number | 8013710060 |
| Enumeration Date | 2007-11-15 |
| Last Update Date | 2010-05-28 |
| Authorized Official Name | ANTHONY C THOMAS (PRESIDENT) |
| Authorized Official Telephone | 8013752711 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers |
| Street Address |
350 W CENTER ST |
| City | PROVO |
| State | UT |
| Zip Code | 84601-4323 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902378417 | 1 Assist Care of Utah Valley LLC | In Home Supportive Care | 180 N University Avenue, Suite 270, Office 213, Provo, UT 84601 | 2018-12-21 |
| 1346723319 | Mp Dental LLC | Dentist | 777 N. 500 W. #204, Proud, UT 84601 | 2018-09-14 |
| 1326530601 | Madison Paige Nelson | Case Manager/Care Coordinator | 750 N Freedom Blvd., Provo, UT 84601 | 2018-06-03 |
| 1245758861 | Annette Roylance | Case Manager/Care Coordinator | 750 North Freedom Boulevard, Suite 300, Provo, UT 84601 | 2017-09-04 |
| 1912422205 | Alexandra Mcbride | Specialist/Technologist | 35 N 300 W #440, Provo, UT 84601 | 2017-08-07 |
| 1932638293 | Audrey Clara Clifton | Case Manager/Care Coordinator | 750 North Freedom Blvd., Provo, UT 84601 | 2017-06-08 |
| 1528514197 | Joseph Hyrum Lewis | Case Manager/Care Coordinator | 750 Freedom Blvd, Provo, UT 84601 | 2016-09-01 |
| 1629427620 | Walker Clements | Case Manager/Care Coordinator | 750 North Freedom Blvd, Provo, UT 84601 | 2016-06-09 |
| 1447611595 | Robert Shirley | Student in an Organized Health Care Education/Training Program | 750 North 200 West, Provo, Ut 84601., Provo, UT 84601 | 2016-03-17 |
| 1700286283 | Brelynn Downs | Student in an Organized Health Care Education/Training Program | 750 North Freedom Blvde, Provo, UT 84601 | 2014-09-03 |
| Find all providers in zip 84601 | ||||
| Taxonomy Code | 332B00000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient’s use in the home and that are usable for an extended period of time. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407334527 | Pacific Medical | Durable Medical Equipment & Medical Supplies | 505 E 500 N, Provo, UT 84606-3047 | 2018-07-31 |
| 1184058810 | Utah Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 1273 N University Ave, Provo, UT 84604-2603 | 2013-08-29 |
| 1659671378 | Compumed, Inc. | Durable Medical Equipment & Medical Supplies | 3909 Foothill Dr, Provo, UT 84604-5376 | 2010-10-28 |
| 1245413772 | Jamestown Eye Care Center LLC | Durable Medical Equipment & Medical Supplies | 3651 N 100 E Ste 250, Provo, UT 84604-4518 | 2007-12-06 |
| 1427119593 | B and H Medical | Durable Medical Equipment & Medical Supplies | 286 W Center St, Provo, UT 84601-4419 | 2006-12-13 |
| 1386741304 | Ihc Health Services Inc | Durable Medical Equipment & Medical Supplies | 289 W 1230 N, Provo, UT 84604-2546 | 2006-09-20 |
| 1316056609 | Thrifty Payless Inc | Durable Medical Equipment & Medical Supplies | 1324 North State Street, Riverside Plaza, Provo, UT 84604-2419 | 2006-08-30 |
| 1437176633 | Sams West Inc | Durable Medical Equipment & Medical Supplies | 1313 S University Ave, Provo, UT 84601-5943 | 2006-07-16 |
| 1760407399 | Smiths Food & Drug Centers Inc | Durable Medical Equipment & Medical Supplies | 350 N Freedom Blvd, Provo, UT 84601-2810 | 2006-07-13 |
| 1437100518 | Shopko Stores Operating Co LLC | Durable Medical Equipment & Medical Supplies | 2266 N University Pkwy, Provo, UT 84604-1510 | 2006-05-13 |
| Find all providers in PROVO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.