Provider Demographics
NPI:1275536153
Name:BECKER ORTHOPEDIC APPLIANCE COMPANY
Entity Type:Organization
Organization Name:BECKER ORTHOPEDIC APPLIANCE COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:PIGGOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-588-7480
Mailing Address - Street 1:635 EXECUTIVE DR
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48083-4536
Mailing Address - Country:US
Mailing Address - Phone:248-588-7480
Mailing Address - Fax:248-588-6961
Practice Address - Street 1:28801 WOODWARD AVE
Practice Address - Street 2:
Practice Address - City:BERKLEY
Practice Address - State:MI
Practice Address - Zip Code:48072-0915
Practice Address - Country:US
Practice Address - Phone:248-399-0030
Practice Address - Fax:248-399-0031
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-24
Last Update Date:2015-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4370215Medicaid
MI0331050005Medicare NSC
MI4370215Medicaid
MI100106OtherCARE CHOICES