Provider Demographics
NPI:1669552329
Name:STRATUS ORTHOPEDIC SUPPLY, INC.
Entity type:Organization
Organization Name:STRATUS ORTHOPEDIC SUPPLY, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-822-2400
Mailing Address - Street 1:3021 LORNA RD
Mailing Address - Street 2:SUITE 302
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35216-4587
Mailing Address - Country:US
Mailing Address - Phone:205-822-2400
Mailing Address - Fax:205-822-5710
Practice Address - Street 1:3021 LORNA RD
Practice Address - Street 2:SUITE 302
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35216-4587
Practice Address - Country:US
Practice Address - Phone:205-822-2400
Practice Address - Fax:205-822-5710
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-17
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
208D00000X
AL604332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL515-24272OtherMEDICAL O&P
AL5321610001Medicare ID - Type UnspecifiedMEDICAL O&P