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NPI Code Detail

MEDICARE: MEDICAL CENTER ORTHOTICS AND PROSTHETICS LLC

MEDICARE: MEDICAL CENTER ORTHOTICS AND PROSTHETICS LLC
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 SupplierMD

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 : 1144300161
Entity Type Code : Organization
Provider Name (Legal Business Name) : MEDICAL CENTER ORTHOTICS AND PROSTHETICS LLC
Provider Business Mailing Address
First Line : 2421 LINDEN LN
Second Line :
City : SILVER SPRING
State : MD
Zip : 20910-1230
Country : US
Telephone Number : 301-585-5347
Fax Number : 301-585-4383
Provider Business Practice Location Address
First Line : 2421 LINDEN LANE
Second Line :
City : SILVER SPRING
State : MD
Zip : 20910-1230
Country : US
Telephone Number : 301-585-5347
Fax Number : 301-585-4383
Authorized Official
Title or Position : DIRECTOR, TREASURER
Name : BRADFORD GARDNER
Credential :
Telephone Number : 615-864-8783
Provider Enumeration Date : 10/16/2006
Last Update Date : 12/11/2025

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