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General NPI Number Information
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NPI Number | 1487733135
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Entity Type | Organization
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Legal Business Name | PRESQUE ISLE ORTHOPEDIC LABORATORY INC.
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Dates
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Enumeration Date | 11/03/2006
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Last Update Date | 05/10/2021
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Provider Practice Location Address
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Address Line | 2440 W 8TH ST
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City | ERIE
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State | PA
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Zip | 16505-4428
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Country | US
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Telephone | 814-838-2349
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Fax | 814-835-8042
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Provider Business Mailing Address
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Address Line | 2440 W 8TH ST
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City | ERIE
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State | PA
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Zip | 16505-4428
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Country | US
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Telephone | 814-838-2349
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Fax | 814-835-8042
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Authorized Official
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Title or Position | COO
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Name | SOLOMON HEIFETZ
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Credential |
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Telephone | 814-838-0099
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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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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