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General NPI Number Information
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NPI Number | 1710202056
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Entity Type | Organization
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Legal Business Name | CPO SERVICES, INC
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Dates
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Enumeration Date | 03/30/2010
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Last Update Date | 09/24/2024
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Provider Practice Location Address
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Address Line | 3030 N. WOODFORD STREET
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City | DECATUR
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State | IL
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Zip | 62526
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Country | US
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Telephone | 217-619-0069
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Fax | 217-875-7038
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Provider Business Mailing Address
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Address Line | 741 W MAIN ST
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City | PEORIA
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State | IL
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Zip | 61606-1953
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Country | US
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Telephone | 800-334-5705
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Fax | 888-663-6322
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Authorized Official
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Title or Position | CEO
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Name | AMIT BHANTI
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Credential | CP, LPO
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Telephone | 309-676-2276
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 222Z00000X
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Taxonomy Name | Orthotist
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License Number | 213000118
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License Number State | IL
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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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Taxonomy #3
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Taxonomy Code | 224P00000X
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Taxonomy Name | Prosthetist
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License Number | 211000225
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License Number State | IL
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