1184725731 NPI number — ABLE ORTHOPEDICS, INC

Table of content: (NPI 1184725731)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1184725731 NPI number — ABLE ORTHOPEDICS, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ABLE ORTHOPEDICS, INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1184725731
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/29/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2030 10TH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PORT HURON
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48060-6217
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
810-985-8006
Provider Business Mailing Address Fax Number:
810-985-6170

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2030 10TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PORT HURON
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48060-6217
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
810-985-8006
Provider Business Practice Location Address Fax Number:
810-985-6170
Provider Enumeration Date:
09/26/2006

Additional Information

Authorized Official

Authorized Official Last Name:
HORN
Authorized Official First Name:
PAUL
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
810-985-8006

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1825492 . This is a "HEALTH ALLIANCE PLAN" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 540G40258 . This is a "BLUE CROSS BLUE SHIELD MI" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 540G40258 . This is a "BLUE CARE NETWORK" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 5929050 . This is a "CIGNA HEALTH CARE" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 1825492 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 540G40258 . This is a "BCBS MI FED. EMPLOYEE PRO" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 540G40258 . This is a "BLUE CROSS MASTER MEDICAL" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 0983934 . This is a "HEALTHPLUS OF MICHIGAN" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 0435520001 . This is a "ABP ADMINISTRATION" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: QMXPR0009327 . This is a "MOLINA HEALTH CARE OF MI" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 510654 . This is a "CARE CHOICES HMO" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 608 . This is a "NORTHWOOD AAA-PAR PROVIDE" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 630050 . This is a "MCARE" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: ABLE6277-001 . This is a "LINKIA, LLC" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 0435520001 . This is a "MEDICARE DMERC A,B,C" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 52562 . This is a "NORTHWOOD NPN-PAR PROVIDE" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".




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