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Pacific Footwear Company, Inc.

Customized Equipment (DME) in Peoria, AZ · enumerated 2010 · authorized official Kevin Clarke, President.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1104148741

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Registry record

Entity type Organization (Type 2)
Legal business name Pacific Footwear Company, Inc.
Other name <Unavail>
Practice address 13660 N 94th Dr, Suite F-2, Peoria, AZ, 85381
Phone (623) 302-9396
Fax (623) 302-9397
Enumeration date Feb 24, 2010
Last updated in NPPES Apr 22, 2025

Taxonomy & classification

332BC3200X Customized Equipment (DME) Suppliers Primary
335E00000X Prosthetic/Orthotic Supplier Suppliers Secondary

Authorized official

Name Kevin Clarke
Title President
Phone (503) 524-9656

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

Who is the authorized official for Pacific Footwear Company, Inc.?
NPPES lists Kevin Clarke (President) as the authorized official for this organization.
What is the NPI number for Pacific Footwear Company, Inc.?
The NPI for Pacific Footwear Company, Inc. is 1104148741, a Type 2 (organization) record in the CMS NPPES registry.

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2025-04-22.