=====================================================
General NPI Number Information
=====================================================
NPI Number | 1891742458
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | AMERICAN PROSTHETICS INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/28/2006
-----------------------------------------------------
Last Update Date | 07/14/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 197 QUINCY AVE
-----------------------------------------------------
City | BRAINTREE
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 02184-2341
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 781-794-9991
-----------------------------------------------------
Fax | 781-794-1769
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 197 QUINCY AVE
-----------------------------------------------------
City | BRAINTREE
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 02184-2341
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 781-794-9991
-----------------------------------------------------
Fax | 781-794-1769
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | MR. JEFFREY P GOODE
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 781-794-9991
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332B00000X
-----------------------------------------------------
Taxonomy Name | Durable Medical Equipment & Medical Supplies
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 335E00000X
-----------------------------------------------------
Taxonomy Name | Prosthetic/Orthotic Supplier
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------