Provider Demographics
NPI:1104121805
Name:TURNBOW PROSTHETICS LLC
Entity type:Organization
Organization Name:TURNBOW PROSTHETICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:KENT
Authorized Official - Middle Name:
Authorized Official - Last Name:TURNBOW
Authorized Official - Suffix:
Authorized Official - Credentials:CP
Authorized Official - Phone:260-244-0099
Mailing Address - Street 1:561 W CONNEXION WAY
Mailing Address - Street 2:SUITE 2
Mailing Address - City:COLUMBIA CITY
Mailing Address - State:IN
Mailing Address - Zip Code:46725-1048
Mailing Address - Country:US
Mailing Address - Phone:260-244-0099
Mailing Address - Fax:888-270-6755
Practice Address - Street 1:561 W CONNEXION WAY
Practice Address - Street 2:SUITE 2
Practice Address - City:COLUMBIA CITY
Practice Address - State:IN
Practice Address - Zip Code:46725-1048
Practice Address - Country:US
Practice Address - Phone:260-244-0099
Practice Address - Fax:888-270-6755
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-11
Last Update Date:2012-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN6501090001Medicare NSC