Provider Demographics
NPI:1508891136
Name:RESTORATIVE INNOVATIONS, INC.
Entity Type:Organization
Organization Name:RESTORATIVE INNOVATIONS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MANOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-630-8400
Mailing Address - Street 1:54 S TROOPER RD
Mailing Address - Street 2:
Mailing Address - City:NORRISTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19403-3060
Mailing Address - Country:US
Mailing Address - Phone:610-630-8400
Mailing Address - Fax:610-630-4408
Practice Address - Street 1:54 S TROOPER RD
Practice Address - Street 2:
Practice Address - City:NORRISTOWN
Practice Address - State:PA
Practice Address - Zip Code:19403-3060
Practice Address - Country:US
Practice Address - Phone:610-630-8400
Practice Address - Fax:610-630-4408
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-12
Last Update Date:2017-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA009115021OtherVA MEDICAID PROVIDER #
PA292954OtherHIGHMARK PROVIDER #
PA0018630630004Medicaid
PA0002056000OtherIBC PROVIDER #
PA1103060001Medicare ID - Type UnspecifiedPROVIDER NUMBER