Provider Demographics
NPI:1689611204
Name:AMERICAN PROSTHETICS INC
Entity Type:Organization
Organization Name:AMERICAN PROSTHETICS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:P
Authorized Official - Last Name:GOODE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-794-9991
Mailing Address - Street 1:197 QUINCY AVE
Mailing Address - Street 2:
Mailing Address - City:BRAINTREE
Mailing Address - State:MA
Mailing Address - Zip Code:02184-2341
Mailing Address - Country:US
Mailing Address - Phone:781-794-9991
Mailing Address - Fax:781-794-1769
Practice Address - Street 1:380 MERRIMACK ST
Practice Address - Street 2:SUITE 3B
Practice Address - City:METHUEN
Practice Address - State:MA
Practice Address - Zip Code:01844-5870
Practice Address - Country:US
Practice Address - Phone:800-634-0606
Practice Address - Fax:781-794-1769
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DYNAMIC ORTHOPEDIC SYSTEMS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-01
Last Update Date:2011-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1519182Medicaid
NH30762083Medicaid
MA1519182Medicaid