BOLAND PROSTHETIC & ORTHOTIC CENTER (NPI# 1164419743) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164419743 |
| Entity Type | Organization |
| Organization Name | BOLAND PROSTHETIC & ORTHOTIC CENTER |
| Practice Address |
110 Osigian Blvd. Warner Robins GA 31088 |
| Practice Telephone | 4789532922 |
| Practice Fax Number | 4789532927 |
| Mailing Telephone | 4789532922 |
| Mailing Fax Number | 4789532927 |
| Enumeration Date | 2005-09-29 |
| Last Update Date | 2017-01-31 |
| Authorized Official Name | MR. PAUL A BOLAND (OWNER, ORTHOTIST/PROSTHETIST) |
| Authorized Official Telephone | 4789532922 |
| Authorized Official Credential | CPO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| Y | 335E00000X | Prosthetic/Orthotic Supplier | NO STATE LICENSU | GA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 00820751B | 05 | |
| GA | 00820751A | 05 |
| Street Address |
110 OSIGIAN BLVD. |
| City | WARNER ROBINS |
| State | GA |
| Zip Code | 31088 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982218921 | Sarah Newman | Pharmacist | 1081 Ga-96, Warner Robins, GA 31088 | 2020-09-08 |
| 1619599115 | Alana Jane Sibley | Registered Nurse | 940 Ga - 96, Warner Robins, GA 31088 | 2020-05-07 |
| 1033779657 | Jodi Lynne Pettygrove | Nurse Practitioner | 115 Havelock Cir, Warner Robins, GA 31088 | 2019-06-17 |
| 1164994901 | Gwendolyn Jordan Taylor | Registered Nurse | 940-c Ga Hwy 96, Same, Warner Robins, GA 31088 | 2018-12-18 |
| 1447721543 | Amy Tanner | Behavioral Analyst | 200 Cresview Church Rd #1806, Warner Robins, GA 31088 | 2018-12-16 |
| 1518435676 | Phoenix Health Center | Case Management | 940 Ga-96, Warner Robins, GA 31088 | 2018-11-07 |
| 1427534320 | Jared Dean Johnson | Social Worker | 146 Lakepointe Drive, Warner Robins, GA 31088 | 2018-07-13 |
| 1285124180 | Cmp Academy & Billing Service | Contractor | 105 S Commercial Circle, Warner Robins, GA 31088 | 2018-05-16 |
| 1730692377 | Benzer Pharmacy | Pharmacy | 150 S Houston Lake Rd Ste 300, Warner Robins, GA 31088 | 2017-11-06 |
| 1821507476 | Timothy Doyle Thomas | Registered Nurse | 940-c Hwy 96, Warner Robins, GA 31088 | 2017-09-27 |
| Find all providers in zip 31088 | ||||
| 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 |
|---|---|---|---|---|
| 1619594389 | Legally Laced | Prosthetic/Orthotic Supplier | 1000 Corporate Pointe Ste 214, Warner Robins, GA 31088-3440 | 2020-06-29 |
| 1790974384 | Simply Irresistible Woman, LLC | Prosthetic/Orthotic Supplier | 115 Margie Dr Ste D, Warner Robins, GA 31093-7582 | 2007-10-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548860810 | Crowns of Love Inc | Prosthetic/Orthotic Supplier | 707 Park Ave Ne Apt 1382, Atlanta, GA 30326-3410 | 2020-10-27 |
| 1447860150 | Shadae Renee Medical Wigs | Prosthetic/Orthotic Supplier | 10719 Alpharetta Hwy # 1792, Roswell, GA 30076-2432 | 2020-08-06 |
| 1114535432 | Beauty Zone2 Medical Wigs | Prosthetic/Orthotic Supplier | 252 Keys Ferry St, Mcdonough, GA 30253-3342 | 2020-07-22 |
| 1093332009 | Jazzy Wigs, Rx | Prosthetic/Orthotic Supplier | 59 Urey Emerson Dr, Richland, GA 31825-6636 | 2020-06-25 |
| 1174147938 | Salon Asya Mignon LLC | Prosthetic/Orthotic Supplier | 4290 Memorial Dr Ste B1, Decatur, GA 30032-1225 | 2020-06-07 |
| 1023630928 | Michelles Beauty Bar | Prosthetic/Orthotic Supplier | 3662 Druid Oaks Dr, Valdosta, GA 31605-6542 | 2020-05-13 |
| 1366063596 | Stylish Styles By Tee | Prosthetic/Orthotic Supplier | 6595 Roswell Rd Ste G1169, Atlanta, GA 30328-3152 | 2020-04-28 |
| 1518503432 | Regina Murff-love | Prosthetic/Orthotic Supplier | 341 Indus Ln, Lawrenceville, GA 30044-3835 | 2019-11-26 |
| 1417508995 | Priscilla Denise Brown | Prosthetic/Orthotic Supplier | 38200 3rd Ave, Fort Gordon, GA 30905 | 2019-09-25 |
| 1811545650 | Salon Bar LLC | Prosthetic/Orthotic Supplier | 4705 Ashford Dunwoody Rd # 4, Dunwoody, GA 30338-5566 | 2019-08-26 |
| Find all providers with the same taxonomy | ||||
| City | WARNER ROBINS |
| Zip Code | 31088 |
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| 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.