Provider Demographics
NPI:1528632502
Name:ALABAMA ARTIFICIAL LIMB & ORTHOPEDIC SERVICE, INC.
Entity type:Organization
Organization Name:ALABAMA ARTIFICIAL LIMB & ORTHOPEDIC SERVICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:BRADFORD
Authorized Official - Middle Name:
Authorized Official - Last Name:GARDNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-864-8783
Mailing Address - Street 1:102 WOODMONT BLVD STE 400
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37205-5217
Mailing Address - Country:US
Mailing Address - Phone:615-865-8790
Mailing Address - Fax:
Practice Address - Street 1:717 HIGHWAY 67 S STE 10
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35603-6351
Practice Address - Country:US
Practice Address - Phone:256-353-7175
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-14
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier