Provider Demographics
NPI:1265494504
Name:PIRO, MARK A (CPO)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:A
Last Name:PIRO
Suffix:
Gender:M
Credentials:CPO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 22832
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68542-2832
Mailing Address - Country:US
Mailing Address - Phone:402-483-8898
Mailing Address - Fax:402-435-5504
Practice Address - Street 1:2222 S 16TH ST STE 220
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68502-3764
Practice Address - Country:US
Practice Address - Phone:402-483-8898
Practice Address - Fax:402-435-5504
Is Sole Proprietor?:No
Enumeration Date:2006-04-03
Last Update Date:2012-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NECPO014451744P3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE08911OtherBCBS
SD1160090001OtherDMERC REGION D
KS6886853101Medicaid
MN191518500Medicaid
SD9156530Medicaid
NE1160090002OtherDMERC REGION D