Provider Demographics
NPI:1134293285
Name:HANGER PROSTHETICS & ORTHOTICS WEST INC
Entity Type:Organization
Organization Name:HANGER PROSTHETICS & ORTHOTICS WEST INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIR OF REIMBURSEMENT
Authorized Official - Prefix:
Authorized Official - First Name:SHERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:PRICE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-493-8288
Mailing Address - Street 1:PO BOX 650846
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75265-0846
Mailing Address - Country:US
Mailing Address - Phone:925-734-0344
Mailing Address - Fax:
Practice Address - Street 1:5880 W LAS POSITAS BLVD
Practice Address - Street 2:SUITE 57
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94588-8552
Practice Address - Country:US
Practice Address - Phone:925-734-0344
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HANGER INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-11-20
Last Update Date:2014-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGXC00022RMedicaid
0340220075Medicare NSC
CAGXC00022RMedicaid