Provider Demographics
NPI:1124478854
Name:ANATOMICAL DESIGNS, INC.
Entity type:Organization
Organization Name:ANATOMICAL DESIGNS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SHANDON
Authorized Official - Middle Name:
Authorized Official - Last Name:HIME
Authorized Official - Suffix:
Authorized Official - Credentials:CPO
Authorized Official - Phone:724-430-1470
Mailing Address - Street 1:8000 JERRY DOVE DRIVE SUITE 104
Mailing Address - Street 2:
Mailing Address - City:BRIDGEPORT
Mailing Address - State:WV
Mailing Address - Zip Code:26330-0000
Mailing Address - Country:US
Mailing Address - Phone:724-430-1470
Mailing Address - Fax:724-430-1472
Practice Address - Street 1:8000 JERRY DOVE DRIVE SUITE 104
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:WV
Practice Address - Zip Code:26330-0000
Practice Address - Country:US
Practice Address - Phone:724-430-1470
Practice Address - Fax:724-430-1472
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ANATOMICAL DESIGNS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-06-14
Last Update Date:2016-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NO LICENSE REQUIRED335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier