MEDICARE: ALABAMA ARTIFICIAL LIMB & ORTHOPEDIC SERVICE

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	062	AL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1184037095
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALABAMA ARTIFICIAL LIMB & ORTHOPEDIC SERVICE

Provider Business Mailing Address
First Line	:	1223 E SOUTH BLVD
Second Line	:
City	:	MONTGOMERY
State	:	AL
Zip	:	36116
Country	:	US
Telephone Number	:	334-284-0250
Fax Number	:	334-280-2853

Provider Business Practice Location Address
First Line	:	3824 ROSEMONT DR
Second Line	:
City	:	COLUMBUS
State	:	GA
Zip	:	31904-5659
Country	:	US
Telephone Number	:	334-284-0250
Fax Number	:

Authorized Official
Title or Position	:	COO
Name	:	AARON KRATOHVIL
Credential	:
Telephone Number	:	615-550-8760

Provider Enumeration Date	:	06/09/2014
Last Update Date	:	10/09/2017

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