Provider Demographics
NPI: | 1225179492 |
---|---|
Name: | UNION ORTHOTICS & PROSTHETICS CO |
Entity Type: | Organization |
Organization Name: | UNION ORTHOTICS & PROSTHETICS CO |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | OWNER CEO |
Authorized Official - Prefix: | MR |
Authorized Official - First Name: | JON |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | LEIMKUEHLER |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | CPO |
Authorized Official - Phone: | 412-688-0347 |
Mailing Address - Street 1: | 3424 LIBERTY AVE |
Mailing Address - Street 2: | |
Mailing Address - City: | PITTSBURGH |
Mailing Address - State: | PA |
Mailing Address - Zip Code: | 15201-1323 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 412-622-2020 |
Mailing Address - Fax: | 412-621-6315 |
Practice Address - Street 1: | 3 GIBRALTER WAY |
Practice Address - Street 2: | |
Practice Address - City: | GREENSBURG |
Practice Address - State: | PA |
Practice Address - Zip Code: | 15601-5613 |
Practice Address - Country: | US |
Practice Address - Phone: | 724-836-6656 |
Practice Address - Fax: | 724-836-8810 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2007-02-09 |
Last Update Date: | 2011-03-16 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 335E00000X | Suppliers | Prosthetic/Orthotic Supplier |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
PA | 0331550003 | Medicare NSC |