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
1	332B00000X	Durable Medical Equipment & Medical Supplies
2	335E00000X	Prosthetic/Orthotic Supplier

Other Identifiers

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