Provider Demographics
NPI:1841547049
Name:NATIONAL PROSTHETICS AND ORTHOTICS, INC.
Entity type:Organization
Organization Name:NATIONAL PROSTHETICS AND ORTHOTICS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:FARAH
Authorized Official - Middle Name:GEORGE
Authorized Official - Last Name:GHAZALA
Authorized Official - Suffix:
Authorized Official - Credentials:CPO, LP
Authorized Official - Phone:859-442-0400
Mailing Address - Street 1:4200 ALEXANDRIA PIKE
Mailing Address - Street 2:SUITE C
Mailing Address - City:COLD SPRING
Mailing Address - State:KY
Mailing Address - Zip Code:41076-3530
Mailing Address - Country:US
Mailing Address - Phone:859-442-0400
Mailing Address - Fax:859-442-0158
Practice Address - Street 1:901 KENTON STATION DR
Practice Address - Street 2:ROOM 115 & 116
Practice Address - City:MAYSVILLE
Practice Address - State:KY
Practice Address - Zip Code:41056-9609
Practice Address - Country:US
Practice Address - Phone:859-442-0400
Practice Address - Fax:859-442-0158
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NATIONAL PROSTHETICS AND ORTHOTICS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-08-07
Last Update Date:2014-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0097227Medicaid
KY7100236130Medicaid
OH0097227Medicaid