MEDICARE: CARLOW ORTHOPEDIC AND PROSTHETICS, 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	0525653	OTHER	RI	AETNA
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	B501036	OTHER	RI	CIGNA
4	97037	OTHER	RI	BLUECROSS BLUESHIELD RI
5	8200104	OTHER	RI	UNITED HEALTHCARE
6	200260	OTHER	RI	BLUECHIP
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1457355976
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARLOW ORTHOPEDIC AND PROSTHETICS, INC

Provider Business Mailing Address
First Line	:	16 COMMERCIAL ST
Second Line	:
City	:	BRANFORD
State	:	CT
Zip	:	06405-2801
Country	:	US
Telephone Number	:	203-483-8488
Fax Number	:	203-483-6085

Provider Business Practice Location Address
First Line	:	1580 PONTIAC AVENUE
Second Line	:
City	:	CRANSTON
State	:	RI
Zip	:	02920-4487
Country	:	US
Telephone Number	:	401-738-6450
Fax Number	:	401-261-8621

Authorized Official
Title or Position	:	CEO
Name	:	MR. DAVID MAHLER
Credential	:	CPO
Telephone Number	:	203-483-8488

Provider Enumeration Date	:	06/13/2005
Last Update Date	:	01/04/2017

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