MARY FREE BED ORTHOTICS AND PROSTHETICS NPI 1528096997

NPI Information

NPI: 1528096997
Provider Name: MARY FREE BED ORTHOTICS AND PROSTHETICS
Classification: Durable Medical Equipment & Medical Supplies - 332BC3200X
Specialization: Customized Equipment
Entity Type: Organization
Doing Business As: MARY FREE BED BRACE AND CORSET SHOP
Address: 360 LAFAYETTE AVE SE
SUITE 330
GRAND RAPIDS, MI
ZIP 49503
Phone: (616) 356-1916

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NPI Details

MARY FREE BED ORTHOTICS AND PROSTHETICS is a customized equipment durable medical equipment medical supplies in Grand Rapids, MI. MARY FREE BED ORTHOTICS AND PROSTHETICS NPI is 1528096997. The provider is registered as an organization entity type.
The provider Is Doing Business As Mary Free Bed Brace And Corset Shop.

The provider's business location address is:

360 LAFAYETTE AVE SE
SUITE 330
GRAND RAPIDS, MI
ZIP 49503-677
Phone: (616) 356-1916
Fax: (616) 356-1868

The provider's authorized official is Mark A Porth .
The authorized official title is Chief Compliance Officer and has the following contact phone number (616) 356-1916.

The enumeration date for this NPI number is 6/28/2006 and was last updated on 7/21/2022.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	332BC3200X	Durable Medical Equipment & Medical Supplies	Customized Equipment		MICHIGAN	Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	874438302	MEDICAID	MICHIGAN
2	530D105100	OTHER	MICHIGAN	BLUE CROSS UPIN

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: 3/30/2025

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