Healthcare Provider Details

I. General information

NPI: 1275563546
Provider Name (Legal Business Name): NATIONAL PROSTHETICS AND ORTHOTICS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/03/2006
Last Update Date: 07/17/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4200 ALEXANDRIA PIKE SUITE C
COLD SPRING KY
41076
US

IV. Provider business mailing address

4200 ALEXANDRIA PIKE SUITE C
COLD SPRING KY
41076
US

V. Phone/Fax

Practice location:
  • Phone: 859-442-0400
  • Fax: 859-442-0158
Mailing address:
  • Phone: 859-442-0400
  • Fax: 859-442-0158

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: MR. FARAH GEORGE GHAZALA
Title or Position: OWNER/PRESIDENT
Credential: CPO, LP
Phone: 859-442-0400