Provider Demographics
NPI:1336128149
Name:ORTHOTEK, INC
Entity Type:Organization
Organization Name:ORTHOTEK, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:A
Authorized Official - Last Name:STEENHOEK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-255-0952
Mailing Address - Street 1:9379 SWANSON BLVD
Mailing Address - Street 2:SUITE C
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50325-6942
Mailing Address - Country:US
Mailing Address - Phone:515-255-0952
Mailing Address - Fax:515-255-1617
Practice Address - Street 1:9379 SWANSON BLVD
Practice Address - Street 2:SUITE C
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50325-6942
Practice Address - Country:US
Practice Address - Phone:515-255-0952
Practice Address - Fax:515-255-1617
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-10
Last Update Date:2015-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0469650Medicaid
IA0469650Medicaid
IA5101640001Medicare NSC