SUSQUEHANNA VALLEY PROSTHETICS & ORTHOTICS INC (NPI# 1932194271) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932194271 |
| Entity Type | Organization |
| Organization Name | SUSQUEHANNA VALLEY PROSTHETICS & ORTHOTICS INC |
| Practice Address |
3120 N Old Trail Shamokin Dam PA 17876 |
| Mailing Address |
Po Box 243 Shamokin Dam PA 17876 |
| Practice Telephone | 5707431414 |
| Practice Fax Number | 5707435215 |
| Mailing Telephone | 5707431414 |
| Mailing Fax Number | 5707435215 |
| Enumeration Date | 2005-09-13 |
| Last Update Date | 2008-01-03 |
| Authorized Official Name | MR. FRANK THOMAS DOMINICK III (OWNER CERTIFIED PROSTHETIST) |
| Authorized Official Telephone | 5707431414 |
| Authorized Official Credential | CP |
| Is Organization Subpart | Y |
| Parent Organization Name | SUSQUEHANNA VALLEY PROSTHETICS & ORTHOTICS INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 335E00000X | Prosthetic/Orthotic Supplier | PA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | HIGHMARK BLUE SHIELD | SU206824 | 01 |
| KEYSTONE HEALTH PLAN | 39HA76 | 01 | |
| PA | GEISINGER HEALTH PLAN | 57492 | 01 |
| BLUE SHIELD | SU206824 | 01 | |
| HEALTH AMERICA | 116173 | 01 | |
| PA | AETNA | 2477665 | 01 |
| PA | CAPITAL BLUE CROSS | 39HA76 | 01 |
| PA | ABP ADMINISTRATION | 28389 | 01 |
| PA | GATEWAY | 1511123 | 01 |
| PA | 0018173000003 | 05 | |
| PA | HEALTH AMERICA | 340622 | 01 |
| Street Address |
3120 N OLD TRAIL |
| City | SHAMOKIN DAM |
| State | PA |
| Zip Code | 17876 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679898340 | Steven Wayne Davis | Pharmacist | 1000 N Susquehanna Trail, Shamokin Dam, PA 17876 | 2010-04-06 |
| 1407098908 | Independence Corporation | Optometrist | 3090 N Susquehanna Trail Rd, Shamokin Dam, PA 17876 | 2009-03-30 |
| 1083786446 | Shamokin Dam Health Center | Chiropractor | 3166 N Old Trail, Shamokin Dam, PA 17876 | 2006-11-14 |
| 1578671079 | John G Lazur Jr. | Dentist | 2 Baldwin Blvd., Shamokin Dam, PA 17876 | 2006-08-26 |
| 1033140017 | K Mart Corp | Pharmacy | North Susquehanna Trail, Shamokin Dam, PA 17876 | 2006-07-06 |
| 1891781118 | Drs Munir & Samad | Internal Medicine | 99 Baldwin Blvd, Shamokin Dam, PA 17876 | 2005-09-22 |
| 1891867255 | Shamokin Dam Health Center | Family Medicine | 3166 N Old Trail, Shamokin Dam, PA 17876 | 2006-11-14 |
| 1962516997 | Mohammad Abdul Samad | Internal Medicine | 99 Baldwin Blvd, Shamokin Dam, PA 17876 | 2006-08-18 |
| 1952369209 | Nalan Reibschied | Emergency Medicine | 99 Baldwin Blvd, Shamokin Dam, PA 17876 | 2006-05-03 |
| 1992828396 | Basant K. Mittal, M.d. P.C. | Clinic/Center | 3032 N. Susquehanna Trail, Routes 11 and 15, Shamokin Dam, PA 17876-0429 | 2007-04-09 |
| Find all providers in zip 17876 | ||||
| Taxonomy Code | 335E00000X |
| Grouping | Suppliers |
| Classification | Prosthetic/Orthotic Supplier |
| An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition. |
| Notes: Source: American Board for Certification in Orthotics, Prosthetics, and Pedorthics, Inc. [7/1/2010: modified, 7/1/2013: modified] Additional Resources: American Board for Certification in Orthotics, Prosthetics and Pedorthics, Inc., www.abcop.org and Board of Certification/Accreditation, International, www.bocusa.org. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366041030 | Lawall At Hershey, Inc | Prosthetic/Orthotic Supplier | 2020 Good Hope Rd Lawall At Hershey Inc, Suite 220, 2nd Floor, Enola, PA 17025-1237 | 2020-10-22 |
| 1518573435 | Harry J. Lawall & Son, Inc. | Prosthetic/Orthotic Supplier | 21 N Main St,harry J. Lawall & Son, Inc, Suite 3, Coopersburg, PA 18036-1561 | 2020-09-16 |
| 1386257871 | Shi Shi Collection | Prosthetic/Orthotic Supplier | 6128 W Jefferson St, Philadelphia, PA 19151-3902 | 2020-08-25 |
| 1003438177 | Tosi's Hair Replacement Clinic, Inc. | Prosthetic/Orthotic Supplier | 390 Slocum Ave, Exeter, PA 18643-1194 | 2020-05-12 |
| 1750900114 | Experience Lemieux | Prosthetic/Orthotic Supplier | 900 N 19th St Unit 3247, Philadelphia, PA 19130-1561 | 2020-04-15 |
| 1164055620 | Hanger Prosthetics & Orthotics Inc | Prosthetic/Orthotic Supplier | 20421 Route 19 Ste 100, Cranberry Township, PA 16066-7514 | 2020-02-12 |
| 1730711193 | Lvhn Scranton Orthopedic Specialists | Prosthetic/Orthotic Supplier | 334 Main St Ste 2, Dickson City, PA 18519-1668 | 2020-02-04 |
| 1528607223 | Agape Traders | Prosthetic/Orthotic Supplier | 562 Independence Rd Ste 142, East Stroudsburg, PA 18301-9702 | 2019-12-27 |
| 1891337051 | Pamela Howard | Prosthetic/Orthotic Supplier | 5805 Germantown Ave Fl 2, Philadelphia, PA 19144-2138 | 2019-10-09 |
| 1174172647 | Cranial Technologies, Inc. | Prosthetic/Orthotic Supplier | 250 Cetronia Rd Ste 306, Allentown, PA 18104-9168 | 2019-09-08 |
| Find all providers with the same taxonomy | ||||
| City | SHAMOKIN DAM |
| Zip Code | 17876 |
Please comment or provide details below to improve the information on SUSQUEHANNA VALLEY PROSTHETICS & ORTHOTICS INC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.