Provider Demographics
NPI:1699185405
Name:REGENCY MEDICAL BRACING AND SUPPLY
Entity Type:Organization
Organization Name:REGENCY MEDICAL BRACING AND SUPPLY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:D.P.M.
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:AINSLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:724-439-3338
Mailing Address - Street 1:160 PITTSBURGH ST
Mailing Address - Street 2:SUITE 3B
Mailing Address - City:UNIONTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15401-2300
Mailing Address - Country:US
Mailing Address - Phone:724-439-3338
Mailing Address - Fax:724-439-3337
Practice Address - Street 1:160 PITTSBURGH ST
Practice Address - Street 2:SUITE 3B
Practice Address - City:UNIONTOWN
Practice Address - State:PA
Practice Address - Zip Code:15401-2300
Practice Address - Country:US
Practice Address - Phone:724-439-3338
Practice Address - Fax:724-439-3337
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WILLIAM AINSLEY, D.P.M.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-05-01
Last Update Date:2014-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC005640213E00000X
332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Multi-Specialty