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EAST SIDE ORTHOTICS & PROSTHETICS INC. NPI 1093350266


NPI Information

NPI: 1093350266
Provider Name: EAST SIDE ORTHOTICS & PROSTHETICS, INC.
Classification: Prosthetic/Orthotic Supplier - 335E00000X
Entity Type: Organization
Address:
91 MADISON ST
EUGENE, OR
ZIP 97402
Phone: (503) 970-8388
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EAST SIDE ORTHOTICS & PROSTHETICS, INC. is a prosthetic orthotic supplier in Eugene, OR. 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. EAST SIDE ORTHOTICS & PROSTHETICS, INC. NPI is 1093350266. The provider is registered as an organization entity type.

The provider's business location address is:

91 MADISON ST
EUGENE, OR
ZIP 97402-013
Phone: (503) 970-8388
Fax: (503) 257-6624

The provider's authorized official is Benjamin Clark .
The authorized official title is Owner/ Clinician and has the following contact phone number (503) 257-6623.

The enumeration date for this NPI number is 11/12/2019 and was last updated on 12/6/2023.


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
1335E00000XProsthetic/Orthotic SupplierYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1500778749MEDICAIDOREGON

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: 4/28/2024

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