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General NPI Number Information
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NPI Number | 1962685149
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Entity Type | Organization
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Legal Business Name | ACME ORTHOPEDIC LABS, LLC
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Dates
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Enumeration Date | 12/11/2007
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Last Update Date | 12/11/2007
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Provider Practice Location Address
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Address Line | 2411 NE LOOP 410 STE 112
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City | SAN ANTONIO
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State | TX
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Zip | 78217-6600
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Country | US
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Telephone | 210-655-5227
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Fax | 210-646-0585
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Provider Business Mailing Address
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Address Line | 2411 NE LOOP 410 STE 112
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City | SAN ANTONIO
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State | TX
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Zip | 78217-6600
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Country | US
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Telephone | 210-655-5227
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Fax | 210-646-0585
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. SHEY CAMPBELL
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Credential |
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Telephone | 210-655-5227
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 0078720
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number | 101148
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License Number State | TX
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