MEDICARE: ATLANTA PROSTHETICS & 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

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	:	1427054386
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ATLANTA PROSTHETICS & ORTHOTICS, INC.

Provider Business Mailing Address
First Line	:	PO BOX 650846
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75265-0846
Country	:	US
Telephone Number	:	404-618-0451
Fax Number	:	404-636-8884

Provider Business Practice Location Address
First Line	:	59 EXECUTIVE PARK S
Second Line	:	SUITE 1300
City	:	ATLANTA
State	:	GA
Zip	:	30329-2208
Country	:	US
Telephone Number	:	404-636-0321
Fax Number	:	404-636-7259

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

Provider Enumeration Date	:	06/24/2005
Last Update Date	:	02/19/2014

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