Provider Demographics
NPI:1154710671
Name:AWARD PROSTHETICS, INC
Entity type:Organization
Organization Name:AWARD PROSTHETICS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CERTIFIED PROSTHETIST
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:VAN DER WAARDE
Authorized Official - Suffix:
Authorized Official - Credentials:CP(C)
Authorized Official - Phone:604-298-0236
Mailing Address - Street 1:3823 HENNING DRIVE
Mailing Address - Street 2:#112
Mailing Address - City:BURNABY
Mailing Address - State:BC
Mailing Address - Zip Code:V5C 6P3
Mailing Address - Country:CA
Mailing Address - Phone:604-298-0236
Mailing Address - Fax:604-298-0254
Practice Address - Street 1:3823 HENNING DRIVE
Practice Address - Street 2:#112
Practice Address - City:BURNABY
Practice Address - State:BC
Practice Address - Zip Code:V5C 6P3
Practice Address - Country:CA
Practice Address - Phone:604-298-0236
Practice Address - Fax:604-298-0254
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-21
Last Update Date:2015-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier