1740495530 NPI number — NATIONAL PROSTHETICS AND ORTHOTICS PLLC

Table of content: (NPI 1740495530)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1740495530 NPI number — NATIONAL PROSTHETICS AND ORTHOTICS PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NATIONAL PROSTHETICS AND ORTHOTICS PLLC
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:
1740495530
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/20/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4200 ALEXANDRIA PIKE
Provider Second Line Business Mailing Address:
SUITE C
Provider Business Mailing Address City Name:
COLD SPRING
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
41076-3530
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
859-442-0400
Provider Business Mailing Address Fax Number:
859-442-0158

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4200 ALEXANDRIA PIKE
Provider Second Line Business Practice Location Address:
SUITE C
Provider Business Practice Location Address City Name:
COLD SPRING
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
41076-3530
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
859-442-0400
Provider Business Practice Location Address Fax Number:
859-442-0158
Provider Enumeration Date:
05/14/2007

Additional Information

Authorized Official

Authorized Official Last Name:
RIZZO
Authorized Official First Name:
RICHARD
Authorized Official Middle Name:
P
Authorized Official Title or Position:
OWNER MANAGER
Authorized Official Telephone Number:
859-442-0400

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 335E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 000000246457 . This is a "BCBS PIN" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 90004938 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2328430 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1023796 . This is a "ACM UHC KY" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 1024081 . This is a "ACM UHC OH." identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".




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