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General NPI Number Information
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NPI Number | 1184313702
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Entity Type | Organization
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Legal Business Name | SHAMROCK PROSTHETICS INC
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Dates
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Enumeration Date | 05/01/2023
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Last Update Date | 09/18/2025
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Provider Practice Location Address
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Address Line | 2647 BUFORD HWY NE
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City | ATLANTA
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State | GA
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Zip | 30324-3239
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Country | US
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Telephone | 706-850-4544
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Fax | 706-622-6556
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Provider Business Mailing Address
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Address Line | 825 KING AVE
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City | ATHENS
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State | GA
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Zip | 30606-2877
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Country | US
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Telephone | 706-850-4544
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Fax | 706-622-6556
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Authorized Official
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Title or Position | PRESIDENT AND CEO
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Name | SUSAN K MCMAHAN
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Credential |
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Telephone | 706-850-4544
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State |
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