Provider Demographics
NPI:1750601944
Name:ADAPTIVE TECHNOLOGIES, LLC
Entity type:Organization
Organization Name:ADAPTIVE TECHNOLOGIES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:
Authorized Official - First Name:AARON
Authorized Official - Middle Name:
Authorized Official - Last Name:KRATOHVIL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-550-8760
Mailing Address - Street 1:102 WOODMONT BLVD.
Mailing Address - Street 2:SUITE 120
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37205
Mailing Address - Country:US
Mailing Address - Phone:615-550-8774
Mailing Address - Fax:615-454-5352
Practice Address - Street 1:1960 SOUTH 17TH STREET
Practice Address - Street 2:SUITE 201
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28401
Practice Address - Country:US
Practice Address - Phone:910-399-4524
Practice Address - Fax:910-399-4532
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BULOW HOLDINGS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-06-10
Last Update Date:2017-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
335E00000X
NC335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1179580005Medicare NSC
1179580003Medicare NSC