1447348818 NPI number — ORTHOTIC & PROSTHETIC SOLUTIONS

Table of content: (NPI 1447348818)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447348818 NPI number — ORTHOTIC & PROSTHETIC SOLUTIONS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ORTHOTIC & PROSTHETIC SOLUTIONS
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
ORTHOTIC SYSTEM SOLUTIONS
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1447348818
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
11115 KENWOOD ROAD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CINCINNATI
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45242-1817
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
513-794-0340
Provider Business Mailing Address Fax Number:
513-794-0341

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
11115 KENWOOD ROAD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CINCINNATI
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45242-1817
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
513-794-0340
Provider Business Practice Location Address Fax Number:
513-794-0341
Provider Enumeration Date:
10/11/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MATCHISON
Authorized Official First Name:
ERIC
Authorized Official Middle Name:
D
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
513-794-0340

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 335E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2573844 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 90002254 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com