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General NPI Number Information
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NPI Number | 1972621365
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Entity Type | Organization
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Legal Business Name | ORTHO MEDICS
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Dates
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Enumeration Date | 03/26/2007
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Last Update Date | 11/29/2007
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Provider Practice Location Address
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Address Line | 8 W 56TH ST
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City | KEARNEY
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State | NE
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Zip | 68847-0503
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Country | US
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Telephone | 308-237-6105
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Fax | 308-237-6106
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Provider Business Mailing Address
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Address Line | 8 W 56TH ST
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City | KEARNEY
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State | NE
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Zip | 68847-0503
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Country | US
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Telephone | 308-237-6105
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Fax | 308-237-6106
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Authorized Official
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Title or Position | C.O.
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Name | MR. JACOB W SIKES
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Credential | C.O.
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Telephone | 308-237-6105
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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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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