Provider Demographics
NPI:1003378217
Name:PA ARTIFICIAL LIMB & BRACE CO., INC
Entity Type:Organization
Organization Name:PA ARTIFICIAL LIMB & BRACE CO., INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:J
Authorized Official - Last Name:SVETZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-868-5231
Mailing Address - Street 1:224 W 26TH ST
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16508-1806
Mailing Address - Country:US
Mailing Address - Phone:814-868-5231
Mailing Address - Fax:814-868-5232
Practice Address - Street 1:917 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:JAMESTOWN
Practice Address - State:NY
Practice Address - Zip Code:14701-3044
Practice Address - Country:US
Practice Address - Phone:888-457-9637
Practice Address - Fax:814-868-5232
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PA ARTIFICIAL LIMB & BRACE CO., INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-04-05
Last Update Date:2019-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies