Provider Demographics
NPI:1053718916
Name:HANGER PROSTHETICS & ORTHOTICS, INC
Entity type:Organization
Organization Name:HANGER PROSTHETICS & ORTHOTICS, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF REIMBURSEMENT
Authorized Official - Prefix:
Authorized Official - First Name:SHERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:PRICE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-493-8288
Mailing Address - Street 1:3691 COUGAR DR STE A
Mailing Address - Street 2:
Mailing Address - City:PERU
Mailing Address - State:IL
Mailing Address - Zip Code:61354-9302
Mailing Address - Country:US
Mailing Address - Phone:815-220-1382
Mailing Address - Fax:815-220-1300
Practice Address - Street 1:3691 COUGAR DR STE A
Practice Address - Street 2:
Practice Address - City:PERU
Practice Address - State:IL
Practice Address - Zip Code:61354-9302
Practice Address - Country:US
Practice Address - Phone:815-220-1382
Practice Address - Fax:815-220-1300
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HANGER INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-11-20
Last Update Date:2015-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
0414330431Medicare NSC