Provider Demographics
NPI:1386730554
Name:ASHLAND PROSTHETIC & ORTHOTIC
Entity type:Organization
Organization Name:ASHLAND PROSTHETIC & ORTHOTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO LICENSED PROSTHETIST/ORTHOTIST
Authorized Official - Prefix:MR
Authorized Official - First Name:ERVIN
Authorized Official - Middle Name:L
Authorized Official - Last Name:STEPP
Authorized Official - Suffix:
Authorized Official - Credentials:LPO
Authorized Official - Phone:606-324-5786
Mailing Address - Street 1:PO BOX 510
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:KY
Mailing Address - Zip Code:41105-0510
Mailing Address - Country:US
Mailing Address - Phone:606-324-5786
Mailing Address - Fax:606-324-5876
Practice Address - Street 1:2816 CARTER AVE
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:KY
Practice Address - Zip Code:41101
Practice Address - Country:US
Practice Address - Phone:606-324-5786
Practice Address - Fax:606-324-5876
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-05
Last Update Date:2016-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYBL200612332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY90080102Medicaid
OH0413640001Medicare NSC
WV0413640001Medicare NSC
KY0413640001Medicare NSC