Provider Demographics
NPI:1669579868
Name:CARLS SHOES INC
Entity type:Organization
Organization Name:CARLS SHOES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CARL
Authorized Official - Middle Name:
Authorized Official - Last Name:BARONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-235-6223
Mailing Address - Street 1:27 WEST MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:MOORESTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08057
Mailing Address - Country:US
Mailing Address - Phone:856-235-6223
Mailing Address - Fax:856-235-7468
Practice Address - Street 1:27 WEST MAIN STREET
Practice Address - Street 2:
Practice Address - City:MOORESTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08057
Practice Address - Country:US
Practice Address - Phone:856-235-6223
Practice Address - Fax:856-235-7468
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2008-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1010095OtherHORIZON NJ HEALTH
NJ2579405Medicaid
NJ1010095OtherHORIZON NJ HEALTH