Provider Demographics
NPI:1609960962
Name:ADAPTIVE TECHNOLOGIES, LLC
Entity Type:Organization
Organization Name:ADAPTIVE TECHNOLOGIES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:
Authorized Official - First Name:AARON
Authorized Official - Middle Name:
Authorized Official - Last Name:KRATOHVIL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-550-8760
Mailing Address - Street 1:102 WOODMONT BLVD.
Mailing Address - Street 2:SUITE 120
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37205
Mailing Address - Country:US
Mailing Address - Phone:615-550-8774
Mailing Address - Fax:615-454-5352
Practice Address - Street 1:2704 WOOTEN BLVD SW
Practice Address - Street 2:
Practice Address - City:WILSON
Practice Address - State:NC
Practice Address - Zip Code:27893
Practice Address - Country:US
Practice Address - Phone:252-291-5858
Practice Address - Fax:252-291-5542
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BULOW HOLDINGS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-03
Last Update Date:2017-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7704336Medicaid
NC7795002Medicaid
NC7795259Medicaid
NC0414LOtherBLUE CROSS BLUE SHIELD
NC7795310Medicaid
NC7795148Medicaid
NC7795214Medicaid
NC7795286Medicaid
NC7795129Medicaid
NC7702039Medicaid
NC7795074Medicaid
NC7795259Medicaid
NC7795214Medicaid
NC7795129Medicaid
NC7795148Medicaid