Provider Demographics
NPI:1013186428
Name:ARCH O & P, INC
Entity Type:Organization
Organization Name:ARCH O & P, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:J
Authorized Official - Last Name:SOLAZZO
Authorized Official - Suffix:SR
Authorized Official - Credentials:LPO, CPO
Authorized Official - Phone:561-572-0305
Mailing Address - Street 1:3347 S STATE ROAD 7 # 206A
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33449-8148
Mailing Address - Country:US
Mailing Address - Phone:561-572-0305
Mailing Address - Fax:561-572-0348
Practice Address - Street 1:3347 S STATE ROAD 7 # 206A
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33449-8148
Practice Address - Country:US
Practice Address - Phone:561-572-0305
Practice Address - Fax:561-572-0348
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-29
Last Update Date:2020-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL031826400Medicaid
FL5690060001Medicare NSC