Provider Demographics
NPI:1205836905
Name:CALUMET ORTHOPEDIC & PROSTHETICS CO INC
Entity Type:Organization
Organization Name:CALUMET ORTHOPEDIC & PROSTHETICS CO INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:WALTER
Authorized Official - Last Name:PAWLOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:CPO
Authorized Official - Phone:219-942-2148
Mailing Address - Street 1:7554 GRAND BLVD
Mailing Address - Street 2:
Mailing Address - City:HOBART
Mailing Address - State:IN
Mailing Address - Zip Code:46342-6672
Mailing Address - Country:US
Mailing Address - Phone:219-942-2148
Mailing Address - Fax:219-947-2143
Practice Address - Street 1:7554 GRAND BLVD
Practice Address - Street 2:
Practice Address - City:HOBART
Practice Address - State:IN
Practice Address - Zip Code:46342-6672
Practice Address - Country:US
Practice Address - Phone:219-942-2148
Practice Address - Fax:219-947-2143
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-26
Last Update Date:2013-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100279560AMedicaid
IN100279560AMedicaid