Provider Demographics
NPI:1184313702
Name:SHAMROCK PROSTHETICS, INC.
Entity type:Organization
Organization Name:SHAMROCK PROSTHETICS, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:FINANCIAL COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAHM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-850-4544
Mailing Address - Street 1:825 KING AVE
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30606-2877
Mailing Address - Country:US
Mailing Address - Phone:706-850-4544
Mailing Address - Fax:706-622-6556
Practice Address - Street 1:2647 BUFORD HWY NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30324-3239
Practice Address - Country:US
Practice Address - Phone:706-850-4544
Practice Address - Fax:706-622-6556
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SHAMROCK PROSTHETICS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-05-01
Last Update Date:2024-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier