Provider Demographics
NPI:1982739991
Name:AMERICAN LIMB & ORTHOPEDIC CO.
Entity Type:Organization
Organization Name:AMERICAN LIMB & ORTHOPEDIC CO.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:NORBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:FLIESS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:574-287-3767
Mailing Address - Street 1:2930 MCKINLEY AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH BEND
Mailing Address - State:IN
Mailing Address - Zip Code:46615-2739
Mailing Address - Country:US
Mailing Address - Phone:574-287-3767
Mailing Address - Fax:574-289-0882
Practice Address - Street 1:201 MORTHLAND DR
Practice Address - Street 2:
Practice Address - City:VALPARAISO
Practice Address - State:IN
Practice Address - Zip Code:46383-6207
Practice Address - Country:US
Practice Address - Phone:219-531-7479
Practice Address - Fax:574-531-0465
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN332BC3200X
IA335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Not Answered335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN0190520004Medicare ID - Type Unspecified