Provider Demographics
NPI:1093711244
Name:PEEPLES ORTHOTICS & PROSTHETICS LLC
Entity Type:Organization
Organization Name:PEEPLES ORTHOTICS & PROSTHETICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:PEEPLES
Authorized Official - Suffix:
Authorized Official - Credentials:CO
Authorized Official - Phone:316-773-5511
Mailing Address - Street 1:7570 W 21ST ST N
Mailing Address - Street 2:STE 1026B
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67205-1734
Mailing Address - Country:US
Mailing Address - Phone:316-773-5511
Mailing Address - Fax:316-773-5587
Practice Address - Street 1:7570 W 21ST ST N
Practice Address - Street 2:STE 1026B
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67205-1734
Practice Address - Country:US
Practice Address - Phone:316-773-5511
Practice Address - Fax:316-773-5587
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-22
Last Update Date:2012-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS6887548801Medicaid
KS4473970001Medicare ID - Type Unspecified