Provider Demographics
NPI:1306001326
Name:ACTION PROSTHETICS
Entity Type:Organization
Organization Name:ACTION PROSTHETICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KARL
Authorized Official - Middle Name:P
Authorized Official - Last Name:BURK
Authorized Official - Suffix:
Authorized Official - Credentials:CP
Authorized Official - Phone:937-339-1123
Mailing Address - Street 1:1498 N BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45331-2454
Mailing Address - Country:US
Mailing Address - Phone:937-548-9100
Mailing Address - Fax:937-548-3055
Practice Address - Street 1:1840 W MAIN ST
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:OH
Practice Address - Zip Code:45373-2304
Practice Address - Country:US
Practice Address - Phone:937-339-1123
Practice Address - Fax:937-339-1124
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-21
Last Update Date:2016-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH6127800001Medicare NSC