AMPUTEE PROSTHETIC CLINIC, CO.; NPI #1013949247

Contact Information

AMPUTEE PROSTHETIC CLINIC, CO.

4900 MERCER UNIVERSITY DR
MACON, GA 31210-6239

Phone: 478-474-5678
Fax: 478-474-5018
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Prosthetic/Orthotic Supplier	335E00000X	51	Medical Supply Company with Orthotist

Indicates primary specialty

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NPI Profile & details for AMPUTEE PROSTHETIC CLINIC, CO.

NPI # 1013949247

LBN Legal business name AMPUTEE PROSTHETIC CLINIC, CO.

Authorized official PAM YOUNG - (OFF. MANAGER/BUSINESS OWNER)

Entity Organization

Organization subpart ¹ No

Enumeration date 07/07/2006

Last updated 01/19/2024 - About 2 years ago

Identifiers

GA	License #	CP2910
GA	Medicaid	408774069B

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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AMPUTEE PROSTHETIC CLINIC, CO.

Contact Information

Specialty

Prosthetic/Orthotic Supplier

NPI Profile & details for AMPUTEE PROSTHETIC CLINIC, CO.

Reviews for AMPUTEE PROSTHETIC CLINIC, CO.