Healthcare Provider Details

I. General information

NPI: 1215137047
Provider Name (Legal Business Name): THE CENTER FOR ORTHOPEDIC RESEARCH AND EDUCATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2007
Last Update Date: 10/31/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19841 N 27TH AVE
PHOENIX AZ
85027-4003
US

IV. Provider business mailing address

14420 W MEEKER BLVD
SUN CITY WEST AZ
85375-5286
US

V. Phone/Fax

Practice location:
  • Phone: 623-537-5600
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: DAVID JACOFSKY
Title or Position: PRESIDENT
Credential: MD
Phone: 623-537-5600