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NPI Code Detail

MEDICARE: NORTH COAST ORTHOTICS AND PROSTHETICS INC

MEDICARE: NORTH COAST ORTHOTICS AND PROSTHETICS INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1335E00000XProsthetic/Orthotic Supplier

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1033185764
Entity Type Code : Organization
Provider Name (Legal Business Name) : NORTH COAST ORTHOTICS AND PROSTHETICS INC
Provider Business Mailing Address
First Line : 6100 S BROADWAY
Second Line : ST# 104
City : LORAIN
State : OH
Zip : 44053-3874
Country : US
Telephone Number : 440-233-4314
Fax Number :
Provider Business Practice Location Address
First Line : 15900 SNOW RD
Second Line : ST# 400
City : BROOKPARK
State : OH
Zip : 44142-2859
Country : US
Telephone Number : 877-236-5501
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : MR. JEFFREY J. YAKOVICH
Credential : C.O.
Telephone Number : 440-233-4314
Provider Enumeration Date : 02/23/2006
Last Update Date : 10/25/2011

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Directions to “NORTH COAST ORTHOTICS AND PROSTHETICS INC ” Practice Location

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