Provider Demographics
NPI:1093873317
Name:CENTRAL ORTHOTIC & PROSTHETIC CO., INC.
Entity Type:Organization
Organization Name:CENTRAL ORTHOTIC & PROSTHETIC CO., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:C
Authorized Official - Last Name:BEEN
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:814-535-8221
Mailing Address - Street 1:725 FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:JOHNSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15901-2823
Mailing Address - Country:US
Mailing Address - Phone:814-535-8221
Mailing Address - Fax:814-536-9047
Practice Address - Street 1:1019 LOGAN BLVD
Practice Address - Street 2:
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16602-4027
Practice Address - Country:US
Practice Address - Phone:814-943-5041
Practice Address - Fax:814-943-5042
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-06
Last Update Date:2016-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007283160006Medicaid
PA0176800005Medicare NSC