MEDICARE: BECKER ORTHOPEDIC APPLIANCE COMPANY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies
2	335E00000X	Prosthetic/Orthotic Supplier

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1275536153
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BECKER ORTHOPEDIC APPLIANCE COMPANY

Provider Business Mailing Address
First Line	:	635 EXECUTIVE DR
Second Line	:
City	:	TROY
State	:	MI
Zip	:	48083-4536
Country	:	US
Telephone Number	:	248-588-7480
Fax Number	:	248-588-6961

Provider Business Practice Location Address
First Line	:	28801 WOODWARD AVE
Second Line	:
City	:	BERKLEY
State	:	MI
Zip	:	48072-0915
Country	:	US
Telephone Number	:	248-399-0030
Fax Number	:	248-399-0031

Authorized Official
Title or Position	:	BUSINESS MANAGER
Name	:	MR. TIMOTHY PIGGOTT
Credential	:
Telephone Number	:	248-588-7480

Provider Enumeration Date	:	05/24/2005
Last Update Date	:	04/02/2015

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