MEDICARE: ALABAMA CENTER FOR PROSTHETICS AND ORTHOTICS, INC.

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	332B00000X	Durable Medical Equipment & Medical Supplies
2	335E00000X	Prosthetic/Orthotic Supplier		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
2	51517049	OTHER	AL	BCBS ALABAMA

General Provider Information

NPI Number	:	1386720845
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALABAMA CENTER FOR PROSTHETICS AND ORTHOTICS, INC.

Provider Business Mailing Address
First Line	:	PO BOX 650846
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75265-0846
Country	:	US
Telephone Number	:	205-595-0632
Fax Number	:	205-595-0612

Provider Business Practice Location Address
First Line	:	3624 5TH AVE S
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35222-2402
Country	:	US
Telephone Number	:	205-595-0632
Fax Number	:	205-595-0612

Authorized Official
Title or Position	:	DIRECTOR OF REIMBURSEMENT
Name	:	MS. SHERYL PRICE
Credential	:
Telephone Number	:	503-493-8288

Provider Enumeration Date	:	10/27/2006
Last Update Date	:	07/31/2014

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