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GREENVILLE ORTHOTICS AND PROSTHETICS LLC NPI 1174544704


NPI Information

NPI: 1174544704
Provider Name: GREENVILLE ORTHOTICS AND PROSTHETICS, LLC

Former Legal Business Name: ORTHOPEDIC SERVICES, INC

Classification: Prosthetic/Orthotic Supplier - 335E00000X
Entity Type: Organization
Address:
135 COMMONWEALTH DR STE 250
GREENVILLE, SC
ZIP 29615
Phone: (864) 552-1840
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GREENVILLE ORTHOTICS AND PROSTHETICS, LLC is a prosthetic orthotic supplier in Greenville, SC. 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. GREENVILLE ORTHOTICS AND PROSTHETICS, LLC NPI is 1174544704. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is Orthopedic Services, Inc.

The provider's business location address is:

135 COMMONWEALTH DR STE 250
GREENVILLE, SC
ZIP 29615-850
Phone: (864) 552-1840
Fax: (864) 552-1841

The provider's authorized official is Joel Richard Vanderwood .
The authorized official title is Owner and has the following contact phone number (864) 552-1840.

The enumeration date for this NPI number is 7/21/2006 and was last updated on 10/5/2021.


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
1DE3917MEDICAIDSOUTH CAROLINA
27749060001OTHERSOUTH CAROLINAMEDICARE PTAN

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

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