MEDICARE: ORTHOTICS & PROSTHETICS REHABILITATION ENGINEERING CENTRE, 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 State	Provider Identifier Issuer
1	000000155607	OTHER	OH	ANTHEM PROVIDER NUMBER
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	80283	OTHER	OH	NPN PROVIDER NUMBER
4	208430	OTHER	OH	HIGHMARK PROVIDER NUMBER

General Provider Information

NPI Number	:	1376527986
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ORTHOTICS & PROSTHETICS REHABILITATION ENGINEERING CENTRE, INC.

Provider Business Mailing Address
First Line	:	1695 NILES CORTLAND RD NE STE 1
Second Line	:
City	:	WARREN
State	:	OH
Zip	:	44484-1165
Country	:	US
Telephone Number	:	330-856-2553
Fax Number	:	330-856-4619

Provider Business Practice Location Address
First Line	:	1695 NILES CORTLAND RD NE STE 1
Second Line	:
City	:	WARREN
State	:	OH
Zip	:	44484-1165
Country	:	US
Telephone Number	:	330-856-2553
Fax Number	:	330-856-4619

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	MRS. DOROTHY J BILLOCK
Credential	:
Telephone Number	:	330-856-2553

Provider Enumeration Date	:	12/06/2005
Last Update Date	:	08/15/2025

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