Provider Demographics
NPI:1306937495
Name:BIO MEDIC APPLIANCES INC
Entity type:Organization
Organization Name:BIO MEDIC APPLIANCES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PROVIDER CONTRACT ANALYST III
Authorized Official - Prefix:
Authorized Official - First Name:GRACE
Authorized Official - Middle Name:
Authorized Official - Last Name:ANGELINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-961-2102
Mailing Address - Street 1:PO BOX 650846
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75265-0846
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8A EWING PL
Practice Address - Street 2:
Practice Address - City:ESSEX JUNCTION
Practice Address - State:VT
Practice Address - Zip Code:05452-2821
Practice Address - Country:US
Practice Address - Phone:802-878-0930
Practice Address - Fax:802-876-5084
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HANGER INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-09-27
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01564507Medicaid
VT0VN0175Medicaid
VTT001857OtherCHAMPUS ID
VT483730OtherCIGNA ID
VT956847OtherMVP ID
NY01564507Medicaid
VT0VN0175Medicaid
VT0331183OtherVERMONT MANAGED CARE ID
VT054-18310OtherBLUE CROSS BLUE SHIELD ID
NY01564507Medicaid
VT03-15390001Medicare ID - Type UnspecifiedMEDICARE ID
VT0315390001Medicare NSC