Provider Demographics
NPI:1326171505
Name:REDSTONE ORTHOTICS, INC.
Entity Type:Organization
Organization Name:REDSTONE ORTHOTICS, INC.
Other - Org Name:FOOT SOLUTIONS, BIRMINGHAM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CERTIFIED PEDORTHIST
Authorized Official - Prefix:MR
Authorized Official - First Name:J. HARRISON
Authorized Official - Middle Name:HARRISON
Authorized Official - Last Name:MOSS
Authorized Official - Suffix:SR
Authorized Official - Credentials:CPED
Authorized Official - Phone:205-991-3338
Mailing Address - Street 1:450 INVERNESS CORNERS
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35242
Mailing Address - Country:US
Mailing Address - Phone:205-991-3338
Mailing Address - Fax:205-991-8338
Practice Address - Street 1:450 INVERNESS CORNERS
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35242
Practice Address - Country:US
Practice Address - Phone:205-991-3338
Practice Address - Fax:205-991-8338
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2011-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL5861930001Medicare NSC