Parkway Shoe Repair Service

LBN: Vivian L Martin
Parkway Shoe Repair Service is an health care organization with primary practice located at 1024 Jordan St , Mount Vernon IL 62864-4231. The organization recently has only one registered license in Suppliers / Prosthetic/Orthotic Supplier, which is considered as the primary health care specialty. Vivian L Martin can be contacted via phone (618) 242-4442, or through Martin, Vivian Lea via phone (618) 242-4442.

Contact Information

Primary practice address
1024 Jordan St Mount Vernon IL 62864-4231
Phone: (618) 242-4442
Fax: (618) 242-3942
Website:
Map and Directions
Authorized official contact:
Name: Martin, Vivian Lea
Phone: (618) 242-4442

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Prosthetic/Orthotic Supplier 335E00000X

Profile Details

NPI number 1194078816
LBN Legal business name Vivian L Martin
DBA Doing business as Parkway Shoe Repair Service
Authorized official Martin, Vivian Lea
Entity Organization
Organization subpart 1 No
Enumeration date Oct 18th, 2012
Last updated Oct 18th, 2012 - about 14 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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