Provider Demographics
NPI:1033487566
Name:AC ORTHOPEDIC SUPPLY
Entity Type:Organization
Organization Name:AC ORTHOPEDIC SUPPLY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORTHOPEDIC SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:
Authorized Official - Last Name:COTE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:616-232-2665
Mailing Address - Street 1:9350 COTTAGE PARK
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48838-7202
Mailing Address - Country:US
Mailing Address - Phone:616-232-2665
Mailing Address - Fax:
Practice Address - Street 1:9350 COTTAGE PARK
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:MI
Practice Address - Zip Code:48838-7202
Practice Address - Country:US
Practice Address - Phone:616-232-2665
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-12
Last Update Date:2011-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MID67225332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies