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PROMYSE-PROSTHETIC ORTHOTIC GROUP NPI 1811961436


NPI Information

NPI: 1811961436
Provider Name: PROMYSE-PROSTHETIC ORTHOTIC GROUP

Doing Business As: CERTIFIED LIMB AND BRACE

Classification: Prosthetic/Orthotic Supplier - 335E00000X
Entity Type: Organization
Address:
3227 PORTLAND AVE
SHREVEPORT, LA
ZIP 71103
Phone: (318) 636-9145
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PROMYSE-PROSTHETIC ORTHOTIC GROUP is a prosthetic orthotic supplier in Shreveport, LA. 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. PROMYSE-PROSTHETIC ORTHOTIC GROUP NPI is 1811961436. The provider is registered as an organization entity type.
The provider Is Doing Business As Certified Limb And Brace.

The provider's business location address is:

3227 PORTLAND AVE
SHREVEPORT, LA
ZIP 71103-026
Phone: (318) 636-9145
Fax: (318) 636-3746

The provider's authorized official is Henry J Richter .
The authorized official title is President and has the following contact phone number (318) 636-9145.

The enumeration date for this NPI number is 2/13/2006 and was last updated on 9/10/2020.


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
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
100440756MEDICAIDMISSISSIPPI
2120085716MEDICAIDARKANSAS
3100802440AMEDICAIDOKLAHOMA
41370371MEDICAIDLOUISIANA
5075470701MEDICAIDTEXAS

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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