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General NPI Number Information
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NPI Number | 1013077064
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Entity Type | Organization
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Legal Business Name | PREMIER HOPE ORTHOTIC & PROSTHETIC ENTERPRISES LLC
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Dates
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Enumeration Date | 12/11/2006
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Last Update Date | 09/22/2025
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Provider Practice Location Address
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Address Line | 1209 ROYAL AVENUE
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City | MONROE
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State | LA
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Zip | 71201
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Country | US
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Telephone | 318-812-0119
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Fax | 318-812-0136
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Provider Business Mailing Address
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Address Line | PO BOX 650846
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City | DALLAS
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State | TX
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Zip | 75265-0846
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | REGULATORY COMPLIANCE ANALYST III
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Name | JENNIFER L SIMMONS
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Credential |
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Telephone | 859-594-2709
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State |
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