Provider Demographics
NPI:1255307419
Name:TUSCALOOSA ORTHOPEDIC APPLIANCE CO INC
Entity Type:Organization
Organization Name:TUSCALOOSA ORTHOPEDIC APPLIANCE CO INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:CARLTON
Authorized Official - Last Name:MASON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-758-5331
Mailing Address - Street 1:508 PAUL BRYANT DR
Mailing Address - Street 2:
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35401-2057
Mailing Address - Country:US
Mailing Address - Phone:205-758-5331
Mailing Address - Fax:205-758-7971
Practice Address - Street 1:508 PAUL BRYANT DR EAST SUITE A
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35401
Practice Address - Country:US
Practice Address - Phone:205-758-5331
Practice Address - Fax:205-758-7971
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL638582332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL52128OtherBLUE CROSS BLUE SHIELD
AL80888OtherNORTHWOOD INSURANCE
AL80888OtherNORTHWOOD INSURANCE