Provider Demographics
NPI:1114632858
Name:R AND J PROSTHETIC APPLIANCE COMPANY, INC.
Entity type:Organization
Organization Name:R AND J PROSTHETIC APPLIANCE COMPANY, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:LOGAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:NEWTON
Authorized Official - Suffix:
Authorized Official - Credentials:CP, BOCO
Authorized Official - Phone:661-323-5944
Mailing Address - Street 1:4517 MARKET ST
Mailing Address - Street 2:SUITE 4
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-7841
Mailing Address - Country:US
Mailing Address - Phone:805-658-1822
Mailing Address - Fax:805-658-1824
Practice Address - Street 1:4517 MARKET ST
Practice Address - Street 2:SUITE 4
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-7841
Practice Address - Country:US
Practice Address - Phone:805-658-1822
Practice Address - Fax:805-658-1824
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-17
Last Update Date:2023-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies