Provider Demographics
NPI:1487728374
Name:ABI ORTHOTIC & PROSTHETIC LABS, INC.
Entity type:Organization
Organization Name:ABI ORTHOTIC & PROSTHETIC LABS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIR OF REIMBURSEMENT
Authorized Official - Prefix:
Authorized Official - First Name:SHERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:PRICE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-493-8288
Mailing Address - Street 1:1834 S LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OH
Mailing Address - Zip Code:44460-4393
Mailing Address - Country:US
Mailing Address - Phone:330-331-0050
Mailing Address - Fax:
Practice Address - Street 1:1834 S LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OH
Practice Address - Zip Code:44460-4393
Practice Address - Country:US
Practice Address - Phone:330-331-0050
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HANGER ORTHOPEDIC GROUP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-11-20
Last Update Date:2009-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2014868Medicaid
0414330325Medicare ID - Type Unspecified
OH2014868Medicaid