Provider Demographics
NPI:1699043778
Name:MAXCARE BIONICS INC
Entity Type:Organization
Organization Name:MAXCARE BIONICS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WILBUR
Authorized Official - Middle Name:A
Authorized Official - Last Name:HAINES
Authorized Official - Suffix:
Authorized Official - Credentials:CPO
Authorized Official - Phone:317-272-9993
Mailing Address - Street 1:1405 JACKSON ST
Mailing Address - Street 2:STE A
Mailing Address - City:COLUMBUS
Mailing Address - State:IN
Mailing Address - Zip Code:47201-5749
Mailing Address - Country:US
Mailing Address - Phone:812-372-2800
Mailing Address - Fax:317-272-7693
Practice Address - Street 1:1405 JACKSON ST
Practice Address - Street 2:STE A
Practice Address - City:COLUMBUS
Practice Address - State:IN
Practice Address - Zip Code:47201-5749
Practice Address - Country:US
Practice Address - Phone:812-372-2800
Practice Address - Fax:317-272-7693
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-05
Last Update Date:2013-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier