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NPI Code Detail

MEDICARE: HANGER PROSTHETICS & ORTHOTICS WEST, INC.

MEDICARE: HANGER PROSTHETICS & ORTHOTICS WEST, 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

General Provider Information

NPI Number : 1629086970
Entity Type Code : Organization
Provider Name (Legal Business Name) : HANGER PROSTHETICS & ORTHOTICS WEST, INC.
Provider Business Mailing Address
First Line : PO BOX 650846
Second Line :
City : DALLAS
State : TX
Zip : 75265-0846
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3663 N LAUGHLIN RD STE 103
Second Line :
City : SANTA ROSA
State : CA
Zip : 95403-9067
Country : US
Telephone Number : 707-528-7999
Fax Number :
Authorized Official
Title or Position : PROVIDER CONTRACT ANALYST III
Name : GRACE ANGELINE
Credential :
Telephone Number : 714-961-2102
Provider Enumeration Date : 08/03/2006
Last Update Date : 11/06/2023

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Directions to “HANGER PROSTHETICS & ORTHOTICS WEST, INC. ” Practice Location

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