MEDICARE: OHIO PROSTHETICS & ORTHOTICS LTD

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	332BC3200X	Customized Equipment (DME)	LPO97	OH

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	:	1740373752
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OHIO PROSTHETICS & ORTHOTICS LTD

Provider Business Mailing Address
First Line	:	1927 WHIPPLE AVE NW
Second Line	:
City	:	CANTON
State	:	OH
Zip	:	44708-2840
Country	:	US
Telephone Number	:	330-479-0087
Fax Number	:	330-479-0097

Provider Business Practice Location Address
First Line	:	1927 WHIPPLE AVE NW
Second Line	:
City	:	CANTON
State	:	OH
Zip	:	44708-1532
Country	:	US
Telephone Number	:	330-479-0087
Fax Number	:	330-479-0097

Authorized Official
Title or Position	:	OWNER PROSTHETIST ORTHOTIST
Name	:	MR. RONALD B ROBINSON
Credential	:	CPO
Telephone Number	:	330-479-0087

Provider Enumeration Date	:	10/02/2006
Last Update Date	:	06/03/2008

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