Provider Demographics
NPI:1396155826
Name:ABILITY PROSTHETICS, LLC
Entity type:Organization
Organization Name:ABILITY PROSTHETICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:CP
Authorized Official - Phone:662-842-3220
Mailing Address - Street 1:223 E FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:TUPELO
Mailing Address - State:MS
Mailing Address - Zip Code:38804-4007
Mailing Address - Country:US
Mailing Address - Phone:662-842-3220
Mailing Address - Fax:662-842-3221
Practice Address - Street 1:223 E FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:TUPELO
Practice Address - State:MS
Practice Address - Zip Code:38804-4007
Practice Address - Country:US
Practice Address - Phone:662-842-3220
Practice Address - Fax:662-842-3221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-06
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
No225000000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotic FitterGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS01605252Medicaid