Healthcare Provider Details

I. General information

NPI: 1699179069
Provider Name (Legal Business Name): ORTHOPEDIC ONE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/14/2014
Last Update Date: 05/24/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

73 SPORTSMAN'S DRIVE
MARENGO OH
43334-1800
US

IV. Provider business mailing address

170 TAYLOR STATION RD
COLUMBUS OH
43213-4491
US

V. Phone/Fax

Practice location:
  • Phone: 614-839-2300
  • Fax: 614-839-2301
Mailing address:
  • Phone: 614-545-7900
  • Fax: 614-545-7901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: JOEL POLITI
Title or Position: AUTHORIZED OFFICIAL
Credential: MD
Phone: 614-545-7900