Provider Demographics
NPI:1962475053
Name:ANATOMICAL DESIGNS, INC.
Entity Type:Organization
Organization Name:ANATOMICAL DESIGNS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHANDON
Authorized Official - Middle Name:H
Authorized Official - Last Name:HIME
Authorized Official - Suffix:
Authorized Official - Credentials:CP, FAAOP
Authorized Official - Phone:724-430-1470
Mailing Address - Street 1:383 DIXON BLVD
Mailing Address - Street 2:
Mailing Address - City:UNIONTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15401-3967
Mailing Address - Country:US
Mailing Address - Phone:724-430-1470
Mailing Address - Fax:724-430-1472
Practice Address - Street 1:511 BURROUGHS ST
Practice Address - Street 2:SUITE 104
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26505-3388
Practice Address - Country:US
Practice Address - Phone:304-284-9190
Practice Address - Fax:304-284-9194
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-09
Last Update Date:2014-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV251812746002OtherMT. STATE BLUE SHIELD
WV6300074000Medicaid
WVDME746OtherTHE HEALTH PLAN
WVDME746OtherTHE HEALTH PLAN
WV6357080002Medicare NSC