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GALLUP LIMB AND BRACE CO INC NPI 1114002219


NPI Information

NPI: 1114002219
Provider Name: GALLUP LIMB AND BRACE CO INC

Other Name: GALLUP ARTIFICIAL LIMB AND BRACE CO INC

Classification: Prosthetist - 224P00000X
Entity Type: Organization
Address:
927 WEST AZTEC AVENUE
GALLUP, NM
ZIP 87301
Phone: (505) 722-5756
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GALLUP LIMB AND BRACE CO INC is a prosthetist in Gallup, NM. The provider is a health care professional who is specifically educated and trained to manage comprehensive prosthetic patient care for individuals who have sustained complete or partial limb loss or absence. Prosthetists assess specific patient needs, formulate an appropriate treatment plan, implement the treatment plan and provide follow-up care. GALLUP LIMB AND BRACE CO INC NPI is 1114002219. The provider is registered as an organization entity type and is a single specialty group.
The provider Other Name Is Gallup Artificial Limb And Brace Co Inc.

The provider's business location address is:

927 WEST AZTEC AVENUE
GALLUP, NM
ZIP 87301
Phone: (505) 722-5756
Fax: (505) 722-6726

The provider's authorized official is Susan M Weaver .
The authorized official title is Owner Vice President and has the following contact phone number (505) 722-5756.

The enumeration date for this NPI number is 10/26/2006 and was last updated on 3/26/2013.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1224P00000XProsthetistCP002174Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
10264640001MEDICARE ID-TYPE UNSPECIFIED
2307852MEDICAIDARIZONA
3T6269MEDICAIDNEW MEXICO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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