MEDICARE: BULOW BIOTECH PROSTHETICS, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	335E00000X	Prosthetic/Orthotic Supplier

General Provider Information

NPI Number	:	1932866217
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BULOW BIOTECH PROSTHETICS, LLC

Provider Business Mailing Address
First Line	:	102 WOODMONT BLVD STE 400
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37205-5217
Country	:	US
Telephone Number	:	615-864-8790
Fax Number	:

Provider Business Practice Location Address
First Line	:	3250 HARDEN STREET EXT STE 200
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29203-6842
Country	:	US
Telephone Number	:	803-768-5090
Fax Number	:

Authorized Official
Title or Position	:	COO
Name	:	BRADFORD GARDNER
Credential	:
Telephone Number	:	615-864-8783

Provider Enumeration Date	:	11/22/2021
Last Update Date	:	06/02/2026

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