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Organization

FOURROUX PROSTHETICS, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. W KEITH WATSON CPO (OWNER/PRESIDENT)
(256) 534-8672
Entity
Organization

Contact information

Practice address
2743 BOB WALLACE AVE SW, HUNTSVILLE, AL 35805-4103
(256) 534-8672
(800) 963-5010
Mailing address
2743 BOB WALLACE AVE SW, HUNTSVILLE, AL 35805-4103
(256) 534-8672
(800) 963-5010

Taxonomy

Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
15
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000050054
AL
05
4581402
TN
01
51050054
BCBS OF ALABAMA
AL
Enumeration date
07/22/2006
Last updated
12/26/2020
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