MEDICARE: PRO-FIT, 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	335E00000X	Prosthetic/Orthotic Supplier	489	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	51033877	OTHER	AL	BLUE CROSS & BLUE SHIELD

General Provider Information

NPI Number	:	1619952447
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRO-FIT, INC.

Provider Business Mailing Address
First Line	:	PO BOX 380248
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35238-0248
Country	:	US
Telephone Number	:	205-326-0050
Fax Number	:	205-324-2226

Provider Business Practice Location Address
First Line	:	2417 3RD AVE S
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35233-2514
Country	:	US
Telephone Number	:	205-326-0050
Fax Number	:	205-324-2226

Authorized Official
Title or Position	:	PRESIDENT/OWNER
Name	:	MR. WALTER ANDREW HOWELL
Credential	:
Telephone Number	:	205-991-7494

Provider Enumeration Date	:	12/14/2005
Last Update Date	:	04/17/2014

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Directions to “PRO-FIT, INC. ” Practice Location

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