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General NPI Number Information
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NPI Number | 1730601527
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Entity Type | Organization
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Legal Business Name | NORTH SHORE PROSTHETICS AND ORTHOTICS INC.
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Dates
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Enumeration Date | 07/12/2017
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Last Update Date | 04/08/2022
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Provider Practice Location Address
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Address Line | 425 KAMEHAMEHA HWY STE 101
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City | PEARL CITY
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State | HI
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Zip | 96782-3238
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Country | US
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Telephone | 808-744-5642
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Fax | 808-892-1456
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Provider Business Mailing Address
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Address Line | 719 KAMEHAMEHA HWY STE B100
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City | PEARL CITY
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State | HI
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Zip | 96782-2771
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Country | US
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Telephone | 808-744-5642
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Fax | 808-892-1456
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Authorized Official
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Title or Position | PRESIDENT
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Name | ERIC WELTON
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Credential |
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Telephone | 808-371-2593
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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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