MEDICARE: ALABAMA ORTHOTICS & PROSTHETICS,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	002	AL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	515-21325	OTHER	AL	BCBS OF ALABAMA

General Provider Information

NPI Number	:	1508852690
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALABAMA ORTHOTICS & PROSTHETICS,INC

Provider Business Mailing Address
First Line	:	1241 MILITARY ST S
Second Line	:
City	:	HAMILTON
State	:	AL
Zip	:	35570-5004
Country	:	US
Telephone Number	:	205-921-7543
Fax Number	:	205-921-4933

Provider Business Practice Location Address
First Line	:	1241 MILITARY ST S
Second Line	:
City	:	HAMILTON
State	:	AL
Zip	:	35570-5004
Country	:	US
Telephone Number	:	205-921-7543
Fax Number	:	205-921-4933

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. JERY O SWANSON
Credential	:	C.P.,L.P.
Telephone Number	:	256-536-5625

Provider Enumeration Date	:	09/23/2005
Last Update Date	:	08/22/2020

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Directions to “ALABAMA ORTHOTICS & PROSTHETICS,INC ” Practice Location

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