Provider Type Icon

EVERGREEN PROSTHETICS AND ORTHOTICS LLC NPI 1023503497


NPI Information

NPI: 1023503497
Provider Name: EVERGREEN PROSTHETICS AND ORTHOTICS, LLC
Classification: Prosthetic/Orthotic Supplier - 335E00000X
Entity Type: Organization
Address:
1818 S 10TH AVE STE 240
CALDWELL, ID
ZIP 83605
Phone: (208) 608-6014
Get Directions

EVERGREEN PROSTHETICS AND ORTHOTICS, LLC is a prosthetic orthotic supplier in Caldwell, ID. The provider is an organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition. EVERGREEN PROSTHETICS AND ORTHOTICS, LLC NPI is 1023503497. The provider is registered as an organization entity type.

The provider's business location address is:

1818 S 10TH AVE STE 240
CALDWELL, ID
ZIP 83605-880
Phone: (208) 608-6014

The provider's authorized official is Timothy L O'neill .
The authorized official title is Owner and has the following contact phone number (503) 407-5408.

The enumeration date for this NPI number is 6/27/2018 and was last updated on 3/23/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1332B00000XDurable Medical Equipment & Medical SuppliesNo
2335E00000XProsthetic/Orthotic SupplierYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.