Provider Demographics
NPI:1407028244
Name:BARANEK & KAPA PROSTHETICS LLC
Entity Type:Organization
Organization Name:BARANEK & KAPA PROSTHETICS LLC
Other - Org Name:ARTISAN PROSTHETICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:IRVING
Authorized Official - Last Name:CRATCH
Authorized Official - Suffix:JR
Authorized Official - Credentials:CP
Authorized Official - Phone:517-336-9300
Mailing Address - Street 1:2035 ASHER CT STE 700
Mailing Address - Street 2:
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48823-8481
Mailing Address - Country:US
Mailing Address - Phone:517-336-9300
Mailing Address - Fax:517-336-9301
Practice Address - Street 1:2035 ASHER CT STE 700
Practice Address - Street 2:
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48823-8481
Practice Address - Country:US
Practice Address - Phone:517-336-9300
Practice Address - Fax:517-336-9301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-01
Last Update Date:2019-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI1753CP335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4914790001Medicare NSC