Provider Demographics
NPI:1962423293
Name:PADGETT LLC
Entity type:Organization
Organization Name:PADGETT LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER MGR
Authorized Official - Prefix:MR
Authorized Official - First Name:NORMAN
Authorized Official - Middle Name:LEWIS
Authorized Official - Last Name:PADGETT
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:334-741-7717
Mailing Address - Street 1:121 N 20TH ST
Mailing Address - Street 2:BLDG 15
Mailing Address - City:OPELIKA
Mailing Address - State:AL
Mailing Address - Zip Code:36801
Mailing Address - Country:US
Mailing Address - Phone:334-741-7717
Mailing Address - Fax:334-741-7742
Practice Address - Street 1:121 N 20TH ST
Practice Address - Street 2:BLDG 15
Practice Address - City:OPELIKA
Practice Address - State:AL
Practice Address - Zip Code:36801
Practice Address - Country:US
Practice Address - Phone:334-741-7717
Practice Address - Fax:334-741-7742
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-21
Last Update Date:2008-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
51098432OtherBCBS
AL009926500Medicaid
AL009926500Medicaid