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General NPI Number Information
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NPI Number | 1841007101
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Entity Type | Organization
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Legal Business Name | ORTHECO LLC
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Dates
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Enumeration Date | 12/11/2024
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Last Update Date | 12/11/2024
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Provider Practice Location Address
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Address Line | 1155 N MAIN ST STE E
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City | GLENDALE HEIGHTS
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State | IL
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Zip | 60139-3508
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Country | US
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Telephone | 872-351-3732
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Fax | 314-461-1713
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Provider Business Mailing Address
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Address Line | 4105 UNION RD
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City | SAINT LOUIS
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State | MO
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Zip | 63129-1064
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Country | US
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Telephone | 314-492-0080
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Fax | 314-461-1713
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. ROMEL BHANTI
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Credential | CP, LP
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Telephone | 217-419-6075
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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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