MEDICARE: AUREA CRANIAL PROSTHETICS L.L.C.

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

General Provider Information

NPI Number	:	1417749011
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AUREA CRANIAL PROSTHETICS L.L.C.

Provider Business Mailing Address
First Line	:	1741 W MARKET ST
Second Line	:	LOFT 18
City	:	AKRON
State	:	OH
Zip	:	44313-7001
Country	:	US
Telephone Number	:	330-524-6602
Fax Number	:	330-524-6602

Provider Business Practice Location Address
First Line	:	1741 W MARKET ST # 18
Second Line	:
City	:	AKRON
State	:	OH
Zip	:	44313-7001
Country	:	US
Telephone Number	:	330-524-6602
Fax Number	:	330-524-6602

Authorized Official
Title or Position	:	OWNER
Name	:	KANDYS THOMAS
Credential	:	PROTHESIS SUPPLIER
Telephone Number	:	330-524-6602

Provider Enumeration Date	:	05/20/2025
Last Update Date	:	02/10/2026

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