Provider Demographics
NPI:1881365641
Name:ASPIRE PROSTHETICS & ORTHOTICS. INC.
Entity type:Organization
Organization Name:ASPIRE PROSTHETICS & ORTHOTICS. INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KNITTEL
Authorized Official - Middle Name:KOFI
Authorized Official - Last Name:ANSA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-430-6100
Mailing Address - Street 1:506 GREENBRIAR RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17404-1335
Mailing Address - Country:US
Mailing Address - Phone:717-916-8246
Mailing Address - Fax:
Practice Address - Street 1:120 S CENTERVILLE RD
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17603-9731
Practice Address - Country:US
Practice Address - Phone:717-430-6100
Practice Address - Fax:717-219-8229
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-22
Last Update Date:2021-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA103094792Medicaid