NPI Code Details Logo

NPI 1629075973

NPI 1629075973 : HANGER PROSTHETICS & ORTHOTICS EAST INC : STATESVILLE, NC

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1629075973
-----------------------------------------------------
    Entity Type          |    Organization 
-----------------------------------------------------
    Legal Business Name  |    HANGER PROSTHETICS & ORTHOTICS EAST INC 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    07/01/2005
-----------------------------------------------------
    Last Update Date     |    01/17/2023
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    744 HARTNESS RD 
-----------------------------------------------------
    City                 |    STATESVILLE
-----------------------------------------------------
    State                |    NC
-----------------------------------------------------
    Zip                  |    28677-3425
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    704-878-9168
-----------------------------------------------------
    Fax                  |    704-861-0655
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    PO BOX 650846 
-----------------------------------------------------
    City                 |    DALLAS
-----------------------------------------------------
    State                |    TX
-----------------------------------------------------
    Zip                  |    75265-0846
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    REG COMPLIANCE SPECIALIST IV
-----------------------------------------------------
    Name                 |     GRACE  ANGELINE 
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    714-961-2102
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    332B00000X
-----------------------------------------------------
    Taxonomy Name        |    Durable Medical Equipment & Medical Supplies
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
    Taxonomy Code        |    332BC3200X
-----------------------------------------------------
    Taxonomy Name        |    Customized Equipment (DME)
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
    Taxonomy Code        |    335E00000X
-----------------------------------------------------
    Taxonomy Name        |    Prosthetic/Orthotic Supplier
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    NC
-----------------------------------------------------



                        

Copyright © 2007-2025 Data Labs Health. All rights reserved.