Provider Demographics
NPI:1316380181
Name:OSS ORTHOPAEDIC HOSPITAL, LLC
Entity Type:Organization
Organization Name:OSS ORTHOPAEDIC HOSPITAL, LLC
Other - Org Name:OSS HEALTH DME WY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHAD
Authorized Official - Middle Name:M
Authorized Official - Last Name:RUTTER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:717-848-4800
Mailing Address - Street 1:1861 POWDER MILL RD.
Mailing Address - Street 2:ATTN MEDICAL STAFF OFFICE
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-4723
Mailing Address - Country:US
Mailing Address - Phone:717-718-2000
Mailing Address - Fax:717-718-3470
Practice Address - Street 1:1665 ROOSEVELT AVE
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17408-8549
Practice Address - Country:US
Practice Address - Phone:717-848-4800
Practice Address - Fax:717-741-9867
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-11
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA332B00000X
335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102569451Medicaid
PA1026569451Medicaid
PA102569451Medicaid
PA1026569451Medicaid
PA226385Medicare PIN