1184725731 NPI number — ABLE ORTHOPEDICS, INC

Table of Contents

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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