Provider Demographics
NPI:1477120319
Name:ANIMATE PEDORTHICS ORTHOTICS PROSTHETICS 4U INC
Entity Type:Organization
Organization Name:ANIMATE PEDORTHICS ORTHOTICS PROSTHETICS 4U INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:
Authorized Official - Last Name:BARRIOS
Authorized Official - Suffix:
Authorized Official - Credentials:PEDORTHIST
Authorized Official - Phone:312-315-6584
Mailing Address - Street 1:307 W SAINT PAUL ST
Mailing Address - Street 2:
Mailing Address - City:SPRING VALLEY
Mailing Address - State:IL
Mailing Address - Zip Code:61362-1860
Mailing Address - Country:US
Mailing Address - Phone:815-663-8418
Mailing Address - Fax:815-410-4158
Practice Address - Street 1:307 W SAINT PAUL ST
Practice Address - Street 2:
Practice Address - City:SPRING VALLEY
Practice Address - State:IL
Practice Address - Zip Code:61362-1860
Practice Address - Country:US
Practice Address - Phone:815-663-8418
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-09
Last Update Date:2021-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies