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General NPI Number Information
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NPI Number | 1578522389
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Entity Type | Organization
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Legal Business Name | ENDURACARE ORTHOTIC & PROSTHETIC SERVICES LLC
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Dates
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Enumeration Date | 03/21/2006
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Last Update Date | 12/28/2012
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Provider Practice Location Address
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Address Line | 638 ROSTRAVER RD SUITE 102
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City | BELLE VERNON
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State | PA
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Zip | 15012-1967
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Country | US
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Telephone | 724-930-8544
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Fax | 724-930-8545
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Provider Business Mailing Address
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Address Line | 638 ROSTRAVER RD SUITE 102
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City | BELLE VERNON
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State | PA
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Zip | 15012-1967
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Country | US
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Telephone | 724-930-8544
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Fax | 724-930-8545
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Authorized Official
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Title or Position | PRESIDENT / CEO
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Name | MR. MICHAEL PAUL SERENARI
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Credential | CO BOCO
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Telephone | 724-930-8544
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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