Healthcare Provider Details

I. General information

NPI: 1326344128
Provider Name (Legal Business Name): ENDURACARE ORTHOTIC AND PROSTHETIC SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/27/2011
Last Update Date: 11/16/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 DANIEL DR SUITE 6
UNIONTOWN PA
15401-8002
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 724-438-7900
  • Fax: 724-438-7903
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 Number6000007742
License Number StatePA

VIII. Authorized Official

Name: MICHAEL PAUL SERENARI
Title or Position: PRESIDENT CEO
Credential: C.O., B.O.C.O.
Phone: 724-350-0457