1912902255 NPI number — ORTHOPEDIC REHABILITATION PRODUCTS

Table of content: (NPI 1912902255)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1912902255 NPI number — ORTHOPEDIC REHABILITATION PRODUCTS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ORTHOPEDIC REHABILITATION PRODUCTS
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:
Provider Other Organization Name Type Code:
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:
1912902255
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/22/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 440956
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
AURORA
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80044-0956
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
720-524-0950
Provider Business Mailing Address Fax Number:
720-524-0383

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5895 E EVANS AVE
Provider Second Line Business Practice Location Address:
STE 102
Provider Business Practice Location Address City Name:
DENVER
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80222-5340
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
720-524-0950
Provider Business Practice Location Address Fax Number:
720-524-0383
Provider Enumeration Date:
06/14/2005

Additional Information

Authorized Official

Authorized Official Last Name:
PRICE
Authorized Official First Name:
SHERYL
Authorized Official Middle Name:
S
Authorized Official Title or Position:
DIRECTOR OF REIMBURSEMENT
Authorized Official Telephone Number:
503-493-8288

Provider Taxonomy Codes

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

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

  • Identifier: 0800660001 . This is a "PALMETTO GBA" identifier . This identifiers is of the category "OTHER".




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