Provider Demographics
NPI:1104017722
Name:NASSE LLC
Entity Type:Organization
Organization Name:NASSE LLC
Other - Org Name:FOOT SOLUTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:GRIMES
Authorized Official - Suffix:
Authorized Official - Credentials:CPED
Authorized Official - Phone:610-775-4950
Mailing Address - Street 1:640 KENHORST PLZ
Mailing Address - Street 2:UNIT 20
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19607-3648
Mailing Address - Country:US
Mailing Address - Phone:610-775-4950
Mailing Address - Fax:610-775-4951
Practice Address - Street 1:640 KENHORST PLZ
Practice Address - Street 2:UNIT 20
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19607-3648
Practice Address - Country:US
Practice Address - Phone:610-775-4950
Practice Address - Fax:610-775-4951
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-08
Last Update Date:2014-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA6012370001Medicare NSC