Healthcare Provider Details
I. General information
NPI: 1750455895
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: 07/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2275 NE DOCTORS DR SUITE 7
BEND OR
97701-6324
US
IV. Provider business mailing address
2275 NE DOCTORS DR SUITE 7
BEND OR
97701-6324
US
V. Phone/Fax
- Phone: 541-389-0633
- Fax: 541-389-5310
- Phone: 541-389-0633
- Fax: 541-389-5310
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 | |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
| # 1 | |
| Identifier | 278270 |
| Identifier Type | MEDICAID |
| Identifier State | OR |
| Identifier Issuer | |
VIII. Authorized Official
Name:
SHERYL
PRICE
Title or Position: DIR OF REIMBURSEMENT
Credential:
Phone: 503-493-8288