MEDICARE: WILLIAMSPORT ORTHOPEDIC & PROSTHETIC COMPANY 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		PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000282784	OTHER	PA	HIGHMARK BLUE CROSS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	37618	OTHER	PA	HEALTH AMERICA
4	814220	OTHER	PA	FIRST PRIORITY HEALTH

General Provider Information

NPI Number	:	1245233642
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WILLIAMSPORT ORTHOPEDIC & PROSTHETIC COMPANY INC

Provider Business Mailing Address
First Line	:	251 PENN ST STE 1
Second Line	:
City	:	WILLIAMSPORT
State	:	PA
Zip	:	17701-5310
Country	:	US
Telephone Number	:	570-322-5277
Fax Number	:	570-322-1289

Provider Business Practice Location Address
First Line	:	251 PENN ST STE 1
Second Line	:
City	:	WILLIAMSPORT
State	:	PA
Zip	:	17701-5310
Country	:	US
Telephone Number	:	570-322-5277
Fax Number	:	570-322-1289

Authorized Official
Title or Position	:	PRESIDENT
Name	:	KATHLEEN BORGESS
Credential	:	BOC-O
Telephone Number	:	570-322-5277

Provider Enumeration Date	:	05/31/2005
Last Update Date	:	08/08/2023

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