1497876007 NPI number — CAPITAL PROSTHETIC AND ORTHOTIC CENTER, INC.

Table of content: (NPI 1497876007)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497876007 NPI number — CAPITAL PROSTHETIC AND ORTHOTIC CENTER, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CAPITAL PROSTHETIC AND ORTHOTIC CENTER, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1497876007
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/23/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4035 NORTHPOINTE DR
Provider Second Line Business Mailing Address:
SUITE A
Provider Business Mailing Address City Name:
ZANESVILLE
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
43701-7647
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
740-453-9545
Provider Business Mailing Address Fax Number:
740-453-1799

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4035 NORTHPOINTE DR
Provider Second Line Business Practice Location Address:
SUITE A
Provider Business Practice Location Address City Name:
ZANESVILLE
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43701-7647
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
740-453-9545
Provider Business Practice Location Address Fax Number:
740-453-1799
Provider Enumeration Date:
04/02/2007

Additional Information

Authorized Official

Authorized Official Last Name:
CRAWFORD
Authorized Official First Name:
LISA
Authorized Official Middle Name:
A
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
614-451-0446

Provider Taxonomy Codes

  • Taxonomy code: 332BC3200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 335E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2930369 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".




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