Organization
AMICI'S ORTHOTICS & PROSTHETICS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KENNETH H NOLL CO (PRESIDENT)
(410) 877-0642
Entity
Organization
Contact information
Practice address
2135 HAMPTON CT, FALLSTON, MD 21047-2020
(410) 877-4160
Mailing address
2135 HAMPTON CT, FALLSTON, MD 21047-2020
(410) 877-4160
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
12203879
MD
335E00000X
Prosthetic/Orthotic Supplier
Primary
12203879
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
400890100
—
MD
01
—
F725
BLUECROSSBLUESHIELD
MD
01
—
MK07AM
BCBS DME PROVIDER #
MD
Enumeration date
10/16/2006
Last updated
08/05/2009
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