Provider Demographics
NPI:1053437947
Name:HAPPY FOOTCARE, LLC
Entity type:Organization
Organization Name:HAPPY FOOTCARE, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:COMPLIANCE
Authorized Official - Prefix:MR
Authorized Official - First Name:CURT
Authorized Official - Middle Name:B
Authorized Official - Last Name:CARLSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-904-4602
Mailing Address - Street 1:206 S 13TH ST
Mailing Address - Street 2:STE 703
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68508-2040
Mailing Address - Country:US
Mailing Address - Phone:402-904-4602
Mailing Address - Fax:402-904-4603
Practice Address - Street 1:206 S 13TH ST
Practice Address - Street 2:STE 703
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68508-2040
Practice Address - Country:US
Practice Address - Phone:402-904-4602
Practice Address - Fax:402-904-4603
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2016-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR164441716Medicaid
5901830001Medicare NSC