| NPI | 1104075332 |
|---|---|
| Doing Business As | FAIR'S SHOE STORE |
| Entity Type | Organization |
| Authorized Contact | CYNTHIA WARREN Managing Member 316-682-1821 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 332900000X Non-Pharmacy Dispensing Site |
| 335E00000X Prosthetic/Orthotic Supplier | |
| Enumeration Date | 2008-09-11 |
| Last Update Date | 2009-01-14 |