Healthcare Provider Details

I. General information

NPI: 1023014743
Provider Name (Legal Business Name): HANGER PROSTHETICS & ORTHOTICS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/27/2005
Last Update Date: 11/08/2023
Certification Date: 11/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9351 GRANT ST STE 410
THORNTON CO
80229-4375
US

IV. Provider business mailing address

PO BOX 650846
DALLAS TX
75265-0846
US

V. Phone/Fax

Practice location:
  • Phone: 303-280-0890
  • Fax: 303-252-0749
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier31556078
Identifier TypeMEDICAID
Identifier StateCO
Identifier Issuer

VIII. Authorized Official

Name: GRACE ANGELINE
Title or Position: PROVIDER CONTRACT ANALYST III
Credential:
Phone: 714-961-2102