Provider Demographics
NPI:1336140011
Name:BURTON PROSTHETICS INC
Entity Type:Organization
Organization Name:BURTON PROSTHETICS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CERTIFIED PROSTHETIST/ORTHOTIST
Authorized Official - Prefix:MR
Authorized Official - First Name:RUSSELL
Authorized Official - Middle Name:F
Authorized Official - Last Name:BURTON
Authorized Official - Suffix:
Authorized Official - Credentials:CPO
Authorized Official - Phone:402-384-1334
Mailing Address - Street 1:5329 CENTER ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68106-2338
Mailing Address - Country:US
Mailing Address - Phone:402-384-1334
Mailing Address - Fax:402-384-1331
Practice Address - Street 1:5329 CENTER ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68106-2338
Practice Address - Country:US
Practice Address - Phone:402-384-1334
Practice Address - Fax:402-384-1331
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-03
Last Update Date:2011-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0560417Medicaid
NE08983OtherBCBS
NE50670604900Medicaid
NE82-00386OtherUNITED HEALTH CARE
NE5725630001Medicare NSC