Provider Demographics
NPI:1114349099
Name:ORTHOCARE MEDICAL EQUIPMENT, LLC
Entity Type:Organization
Organization Name:ORTHOCARE MEDICAL EQUIPMENT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KERRIANN
Authorized Official - Middle Name:
Authorized Official - Last Name:CATLAW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-668-6688
Mailing Address - Street 1:700 LAKE AVE
Mailing Address - Street 2:SUITE 6
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03103-2734
Mailing Address - Country:US
Mailing Address - Phone:603-668-6688
Mailing Address - Fax:603-668-6689
Practice Address - Street 1:192 TILLEY DR
Practice Address - Street 2:SUITE 1142
Practice Address - City:SOUTH BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05403-4440
Practice Address - Country:US
Practice Address - Phone:802-847-5865
Practice Address - Fax:802-847-8830
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-13
Last Update Date:2014-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
5467630005Medicare NSC