Provider Demographics
NPI:1417021569
Name:ABI ORTHOTIC AND PROSTHETIC LABS LTD
Entity Type:Organization
Organization Name:ABI ORTHOTIC AND PROSTHETIC LABS LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIR OF REIMBURSEMENT
Authorized Official - Prefix:
Authorized Official - First Name:SHERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:PRICE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-493-8288
Mailing Address - Street 1:2807 WILMINGTON RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:NEW CASTLE
Mailing Address - State:PA
Mailing Address - Zip Code:16105-1263
Mailing Address - Country:US
Mailing Address - Phone:724-652-4209
Mailing Address - Fax:
Practice Address - Street 1:2807 WILMINGTON RD
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:PA
Practice Address - Zip Code:16105-1263
Practice Address - Country:US
Practice Address - Phone:724-652-4209
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Not Answered335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007451390001Medicaid
OH2014804Medicaid
PA1007451390001Medicaid