Provider Demographics
NPI:1932388048
Name:BIO-DESIGNS PROSTHETICS, LLC
Entity type:Organization
Organization Name:BIO-DESIGNS PROSTHETICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:TIEN
Authorized Official - Middle Name:QUANG
Authorized Official - Last Name:TRAN
Authorized Official - Suffix:
Authorized Official - Credentials:CP, LO, FAAOP
Authorized Official - Phone:901-737-5738
Mailing Address - Street 1:748 WALNUT KNOLL LN
Mailing Address - Street 2:
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38018-3110
Mailing Address - Country:US
Mailing Address - Phone:901-737-5738
Mailing Address - Fax:901-737-5692
Practice Address - Street 1:748 WALNUT KNOLL LN
Practice Address - Street 2:
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38018-3110
Practice Address - Country:US
Practice Address - Phone:901-737-5738
Practice Address - Fax:901-737-5692
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-25
Last Update Date:2012-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNORT0000000180335E00000X
TNPRO0000000084335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1455244Medicaid
TN6016080001Medicare NSC