Provider Demographics
NPI:1689764839
Name:ABLE ORTHOPEDICS, INC
Entity Type:Organization
Organization Name:ABLE ORTHOPEDICS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:HORN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-985-8006
Mailing Address - Street 1:2030 10TH ST
Mailing Address - Street 2:
Mailing Address - City:PORT HURON
Mailing Address - State:MI
Mailing Address - Zip Code:48060-6217
Mailing Address - Country:US
Mailing Address - Phone:810-985-8006
Mailing Address - Fax:
Practice Address - Street 1:14715 NORTHLINE RD
Practice Address - Street 2:
Practice Address - City:SOUTHGATE
Practice Address - State:MI
Practice Address - Zip Code:48195-2407
Practice Address - Country:US
Practice Address - Phone:734-281-3775
Practice Address - Fax:810-985-8006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-16
Last Update Date:2008-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2855235Medicaid
MI0435520004Medicare ID - Type Unspecified
MI0435520004Medicare NSC