Provider Demographics
NPI:1518904358
Name:BIO-TECH ORTHOTIC & PROSTHETIC SERVICES, LLC
Entity Type:Organization
Organization Name:BIO-TECH ORTHOTIC & PROSTHETIC SERVICES, LLC
Other - Org Name:STEVEN J SMITH SOLE MBR
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:TYLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-600-2072
Mailing Address - Street 1:4895 WINDWARD PKWY STE 103
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30004-3850
Mailing Address - Country:US
Mailing Address - Phone:404-600-2072
Mailing Address - Fax:770-558-6190
Practice Address - Street 1:4895 WINDWARD PKWY STE 103
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30004-3850
Practice Address - Country:US
Practice Address - Phone:404-600-2072
Practice Address - Fax:770-558-6190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-01
Last Update Date:2020-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X
FLPOR52335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL5712610001Medicare NSC