Provider Demographics
NPI:1770778193
Name:ADAPTIVE TECHNOLOGIES, LLC
Entity type:Organization
Organization Name:ADAPTIVE TECHNOLOGIES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:BRADFORD
Authorized Official - Middle Name:
Authorized Official - Last Name:GARDNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-864-8783
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:37205-2287
Mailing Address - Country:US
Mailing Address - Phone:615-550-8774
Mailing Address - Fax:615-454-5352
Practice Address - Street 1:2680 HENDERSON DR STE 3
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28546-5297
Practice Address - Country:US
Practice Address - Phone:910-219-1455
Practice Address - Fax:910-219-1456
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BULOW HOLDINGS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-09-10
Last Update Date:2023-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332BC3200X
NC335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0414LOtherBLUE CROSS BLUE SHIELD
NC1179580004Medicare NSC