Fred'S Boot Shop
Durable Medical Equipment & Medical Supplies in Rochester, NY. Organization (NPI-2).
NPI number1841362001
StatusActive
Last updated in NPPESAug 22, 2020
Details
- NPI
- 1841362001
- Entity type
- Organization (NPI-2)
- Legal business name
- Fred'S Boot Shop
- Organization subpart
- No
- Enumeration date
- Nov 14, 2006
- Last updated
- Aug 22, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 332B00000X | Durable Medical Equipment & Medical Supplies | – | – | Yes |
Practice location
2854 Dewey AveRochester, NY 14616-4630
Phone 585-303-1886 · Fax 585-227-8562
Mailing address
186 Red Hickory DrRochester, NY 14626-4033
Phone 585-303-1886 · Fax 585-227-8562
Authorized official
Ignazio Cancellieri
Owner
5853031886
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