Healthcare Provider Details

I. General information

NPI: 1750403275
Provider Name (Legal Business Name): HANGER PROSTHETICS & ORTHTOTICS WEST INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2007
Last Update Date: 01/17/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2800 E AJO WAY SUITE C
TUCSON AZ
85713-6204
US

IV. Provider business mailing address

3540 E BASELINE RD SUITE 100
PHOENIX AZ
85042-9627
US

V. Phone/Fax

Practice location:
  • Phone: 520-889-7800
  • Fax: 520-889-7803
Mailing address:
  • Phone: 602-426-8896
  • Fax: 602-426-8895

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: SHERYL PRICE
Title or Position: DIRECTOR OF REIMBURSEMENT
Credential:
Phone: 503-493-8288