Healthcare Provider Details
I. General information
NPI: 1255405304
Provider Name (Legal Business Name): HANGER PROSTHETICS & ORTHOTICS INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/20/2006
Last Update Date: 05/03/2024
Certification Date: 05/03/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
456 SAINT LUKES DR
MONTGOMERY AL
36117-7104
US
IV. Provider business mailing address
PO BOX 650846
DALLAS TX
75265-0846
US
V. Phone/Fax
- Phone: 334-396-0405
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 335E00000X |
| Taxonomy | Prosthetic/Orthotic Supplier |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
GRACE
ANGELINE
Title or Position: PROVIDER CONTRACT ANALYST III
Credential:
Phone: 714-961-2102