Provider Demographics
NPI:1508179847
Name:AMERICAN PROSTHETIC AND ORTHOTIC CARE LLC.
Entity Type:Organization
Organization Name:AMERICAN PROSTHETIC AND ORTHOTIC CARE LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:SHAMSHAD
Authorized Official - Middle Name:
Authorized Official - Last Name:AHMED
Authorized Official - Suffix:
Authorized Official - Credentials:CPO
Authorized Official - Phone:304-521-4988
Mailing Address - Street 1:223 26TH ST
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25703-1630
Mailing Address - Country:US
Mailing Address - Phone:304-521-4988
Mailing Address - Fax:304-521-4896
Practice Address - Street 1:223 26TH ST
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25703-1630
Practice Address - Country:US
Practice Address - Phone:304-521-4988
Practice Address - Fax:304-521-4896
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-15
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC15500335E00000X
VACPO02136335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810017976Medicaid
OH3155160Medicaid
KY7100146440Medicaid
6424360001Medicare NSC