Healthcare Provider Details

I. General information

NPI: 1578522389
Provider Name (Legal Business Name): ENDURACARE ORTHOTIC & PROSTHETIC SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/21/2006
Last Update Date: 12/28/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

638 ROSTRAVER RD SUITE 102
BELLE VERNON PA
15012-1967
US

IV. Provider business mailing address

638 ROSTRAVER RD SUITE 102
BELLE VERNON PA
15012-1967
US

V. Phone/Fax

Practice location:
  • Phone: 724-930-8544
  • Fax: 724-930-8545
Mailing address:
  • Phone: 724-930-8544
  • Fax: 724-930-8545

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: MR. MICHAEL PAUL SERENARI
Title or Position: PRESIDENT / CEO
Credential: CO BOCO
Phone: 724-930-8544