Provider Demographics
NPI:1215231840
Name:HI TECH PROSTHETICS INC
Entity Type:Organization
Organization Name:HI TECH PROSTHETICS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROSTHETIST
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:
Authorized Official - Last Name:UCROS
Authorized Official - Suffix:
Authorized Official - Credentials:CP
Authorized Official - Phone:787-891-4805
Mailing Address - Street 1:HC 3 BOX 25720
Mailing Address - Street 2:
Mailing Address - City:SAN GERMAN
Mailing Address - State:PR
Mailing Address - Zip Code:00683-9353
Mailing Address - Country:US
Mailing Address - Phone:787-264-4805
Mailing Address - Fax:787-882-9045
Practice Address - Street 1:HC 3 BOX 25720
Practice Address - Street 2:
Practice Address - City:SAN GERMAN
Practice Address - State:PR
Practice Address - Zip Code:00683-9353
Practice Address - Country:US
Practice Address - Phone:787-264-4805
Practice Address - Fax:787-882-9045
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-22
Last Update Date:2011-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DECP003218335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR4218610001Medicare NSC