Provider Demographics
NPI:1932345964
Name:BUTTE PROSTHETICS
Entity type:Organization
Organization Name:BUTTE PROSTHETICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:E
Authorized Official - Last Name:THURMAN
Authorized Official - Suffix:
Authorized Official - Credentials:CP
Authorized Official - Phone:530-893-4255
Mailing Address - Street 1:2260 ESPLANADE
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926-2234
Mailing Address - Country:US
Mailing Address - Phone:530-893-4255
Mailing Address - Fax:530-893-4265
Practice Address - Street 1:2260 ESPLANADE
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-2234
Practice Address - Country:US
Practice Address - Phone:530-893-4255
Practice Address - Fax:530-893-4265
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-22
Last Update Date:2008-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0190550001Medicare NSC