Provider Demographics
NPI:1417260662
Name:AMERICAN PROSTHETICS, INC
Entity Type:Organization
Organization Name:AMERICAN PROSTHETICS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:P
Authorized Official - Last Name:GOODE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-794-9991
Mailing Address - Street 1:197 QUINCY AVE
Mailing Address - Street 2:
Mailing Address - City:BRAINTREE
Mailing Address - State:MA
Mailing Address - Zip Code:02184-2341
Mailing Address - Country:US
Mailing Address - Phone:781-794-9991
Mailing Address - Fax:781-794-1769
Practice Address - Street 1:197 QUINCY AVE
Practice Address - Street 2:
Practice Address - City:BRAINTREE
Practice Address - State:MA
Practice Address - Zip Code:02184-2341
Practice Address - Country:US
Practice Address - Phone:781-794-9991
Practice Address - Fax:781-794-1769
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DYNAMIC ORTHOPEDIC SYSTEMS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-07-16
Last Update Date:2010-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0418490001Medicare NSC