Provider Demographics
NPI:1639276066
Name:ADVANCED PROSTHETICS OF AMERICA, INC.
Entity Type:Organization
Organization Name:ADVANCED PROSTHETICS OF AMERICA, INC.
Other - Org Name:HANGER CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF REIMBURSEMENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SHERYL
Authorized Official - Middle Name:S
Authorized Official - Last Name:PRICE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-493-8288
Mailing Address - Street 1:PO BOX 650846
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75265-0846
Mailing Address - Country:US
Mailing Address - Phone:800-330-8881
Mailing Address - Fax:800-261-9537
Practice Address - Street 1:2763 W OLD US HWY 441
Practice Address - Street 2:
Practice Address - City:MOUNT DORA
Practice Address - State:FL
Practice Address - Zip Code:32757-3500
Practice Address - Country:US
Practice Address - Phone:800-330-8881
Practice Address - Fax:800-261-9537
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HANGER, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-09-20
Last Update Date:2014-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X
FLHCC4459335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000449600Medicaid
FL1683602OtherCIGNA
FL2331574OtherAETNA HMO
FLM2505OtherBCBS FL
FL82-80128OtherACM
FL51086OtherBCBS MI
FL9107700300OtherACESS HEALTH SOLUTIONS
FL008192OtherFL HEALTHCARE
FL145048OtherSTAYWELL, WELLCARE, HEALT
FL51086OtherABP
FL211935OtherAMERIGROUP
FL50135OtherFOUNDATION
FL000006879OtherBEECH STREET
FL276554OtherAVMED
FL5688143OtherAETNA PPO
FL=========OtherHEALTH FIRST
FL50135OtherFOUNDATION
FL1683602OtherCIGNA
FL2331574OtherAETNA HMO