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NPI Code Detail

MEDICARE: PROSTHETIC CARE INC

MEDICARE: PROSTHETIC CARE 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
1332B00000XDurable Medical Equipment & Medical Supplies
2335E00000XProsthetic/Orthotic Supplier

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1417951930
Entity Type Code : Organization
Provider Name (Legal Business Name) : PROSTHETIC CARE INC
Provider Business Mailing Address
First Line : 1009 GROVE RD
Second Line : STE B1
City : GREENVILLE
State : SC
Zip : 29605-4658
Country : US
Telephone Number : 864-370-2010
Fax Number : 864-370-1611
Provider Business Practice Location Address
First Line : 1009 GROVE RD
Second Line : STE B1
City : GREENVILLE
State : SC
Zip : 29605-4658
Country : US
Telephone Number : 864-370-2010
Fax Number : 864-370-1611
Authorized Official
Title or Position : DIRECTOR OF REIMBURSEMENT
Name : SHERYL SHEFFIELD PRICE
Credential :
Telephone Number : 503-493-8288
Provider Enumeration Date : 06/13/2005
Last Update Date : 10/24/2012

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Directions to “PROSTHETIC CARE INC ” Practice Location

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