MEDICARE: UNITED 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
1	335E00000X	Prosthetic/Orthotic Supplier

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	8200039	OTHER	EVERCARE
2	983356	OTHER	NETWORK HEALTH
3	000000005606	OTHER	BOSTON MEDICAL CENTER HEL
4	0143800	OTHER	WASHINGTON WIC
5	700010	OTHER	HCHP
6	000155	OTHER	TUFTS
7	0007137	OTHER	NEIGHBORHOOD HEALTH PLAN
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9	359854	OTHER	BCBS

General Provider Information

NPI Number	:	1134127061
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNITED PROSTHETICS, INC

Provider Business Mailing Address
First Line	:	295 COLUMBIA RD
Second Line	:
City	:	DORCHESTER
State	:	MA
Zip	:	02121-3409
Country	:	US
Telephone Number	:	617-436-6110
Fax Number	:	617-436-2424

Provider Business Practice Location Address
First Line	:	295 COLUMBIA RD
Second Line	:
City	:	DORCHESTER
State	:	MA
Zip	:	02121-3409
Country	:	US
Telephone Number	:	617-436-6110
Fax Number	:	617-436-2424

Authorized Official
Title or Position	:	BOOKKEEPER/OWNER
Name	:	MS. MARY A MARTINO
Credential	:
Telephone Number	:	617-436-6110

Provider Enumeration Date	:	07/13/2005
Last Update Date	:	03/12/2019

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Directions to “UNITED PROSTHETICS, INC ” Practice Location

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