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ORTHOTIC AND PROSTHETIC LAB INC NPI 1265593115


NPI Information

NPI: 1265593115
Provider Name: ORTHOTIC AND PROSTHETIC LAB, INC
Classification: Prosthetic/Orthotic Supplier - 335E00000X
Entity Type: Organization
Address:
4921 PARKVIEW PL
SUITE 13D
SAINT LOUIS, MO
ZIP 63110
Phone: (314) 361-6789
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ORTHOTIC AND PROSTHETIC LAB, INC is a prosthetic orthotic supplier in Saint Louis, MO. 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. ORTHOTIC AND PROSTHETIC LAB, INC NPI is 1265593115. The provider is registered as an organization entity type.

The provider's business location address is:

4921 PARKVIEW PL
SUITE 13D
SAINT LOUIS, MO
ZIP 63110-032
Phone: (314) 361-6789

The provider's authorized official is David J Osterman .
The authorized official title is Owner and has the following contact phone number (314) 968-8555.

The enumeration date for this NPI number is 12/13/2006 and was last updated on 2/16/2017.


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 Supplier213.000099ILLINOISYes
3335E00000XProsthetic/Orthotic Supplier211.000024ILLINOISNo

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
1621818608MEDICAIDMISSOURI

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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