Organization · Type 2 NPI

Pacific Footwear Company, Inc.

Customized Equipment (DME) · Peoria, AZ

NPI number 1104148741 Active

Practice location

13660 N 94th Dr, Suite F-2
Peoria, AZ 85381-4836

Call (623) 302-9396 Map

Fax (623) 302-9397

Mailing address

10240 SW Nimbus Ave, Suite L1
Portland, OR 97223-4358

Specialties and licenses

TaxonomyCodeLicense
Customized Equipment (DME) Primary 332BC3200XNone listed
Prosthetic/Orthotic Supplier 335E00000XNone listed

Customized Equipment (DME): Definition to come...

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About NPI 1104148741

Pacific Footwear Company, Inc.'s National Provider Identifier is 1104148741, issued on Feb 24, 2010. The primary taxonomy on file is Customized Equipment (DME) (332BC3200X), and the practice location is in Peoria, AZ. The record was last updated on Apr 22, 2025.