MEDICARE: CAPITAL PROSTHETIC AND ORTHOTIC CENTER, 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	332BC3200X	Customized Equipment (DME)	LPO 60	OH
2	335E00000X	Prosthetic/Orthotic Supplier	LPO 60	OH

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

General Provider Information

NPI Number	:	1811018609
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAPITAL PROSTHETIC AND ORTHOTIC CENTER, INC.

Provider Business Mailing Address
First Line	:	4678 LARWELL DR
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43220-3621
Country	:	US
Telephone Number	:	614-451-0446
Fax Number	:	614-451-2126

Provider Business Practice Location Address
First Line	:	4678 LARWELL DR
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43220-3621
Country	:	US
Telephone Number	:	614-451-0446
Fax Number	:	614-451-2126

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MRS. LISA J. CRAWFORD
Credential	:	OWNER
Telephone Number	:	614-451-0446

Provider Enumeration Date	:	04/02/2007
Last Update Date	:	07/23/2020

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