Provider Demographics
NPI:1083420277
Name:BAIREFOOT ENTERPRISES LLC
Entity type:Organization
Organization Name:BAIREFOOT ENTERPRISES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHAWN
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:BAIREFOOT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-309-1542
Mailing Address - Street 1:34 APPLEWAY DR APT 1
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901-1608
Mailing Address - Country:US
Mailing Address - Phone:406-309-1542
Mailing Address - Fax:
Practice Address - Street 1:34 APPLEWAY DR APT 1
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-1608
Practice Address - Country:US
Practice Address - Phone:406-309-1542
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-03
Last Update Date:2024-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes344600000XTransportation ServicesTaxi