Provider Demographics
NPI:1497932354
Name:ADVANCED BIOMECHANICS INC
Entity Type:Organization
Organization Name:ADVANCED BIOMECHANICS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:CLIFFORD
Authorized Official - Last Name:O'GUINN
Authorized Official - Suffix:
Authorized Official - Credentials:CPO
Authorized Official - Phone:907-398-1541
Mailing Address - Street 1:215 N FIREWEED ST
Mailing Address - Street 2:
Mailing Address - City:SOLDOTNA
Mailing Address - State:AK
Mailing Address - Zip Code:99669-7540
Mailing Address - Country:US
Mailing Address - Phone:907-262-1515
Mailing Address - Fax:907-262-9515
Practice Address - Street 1:215 N FIREWEED ST
Practice Address - Street 2:
Practice Address - City:SOLDOTNA
Practice Address - State:AK
Practice Address - Zip Code:99669-7540
Practice Address - Country:US
Practice Address - Phone:907-262-1515
Practice Address - Fax:907-262-9515
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-23
Last Update Date:2010-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK6069320001Medicare NSC