Provider Demographics
NPI:1346548633
Name:CENTER FOR ORTHOPEDIC RESEARCH AND EDUCATION, INC.
Entity Type:Organization
Organization Name:CENTER FOR ORTHOPEDIC RESEARCH AND EDUCATION, INC.
Other - Org Name:THE CORE INSTITUTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHAIRMAN
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:JACOFSKY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:623-537-5600
Mailing Address - Street 1:3010 W AGUA FRIA FWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85027-3943
Mailing Address - Country:US
Mailing Address - Phone:623-474-3498
Mailing Address - Fax:623-455-7120
Practice Address - Street 1:1820 W MARYLAND AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85015-1740
Practice Address - Country:US
Practice Address - Phone:623-537-5600
Practice Address - Fax:866-939-2673
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-10
Last Update Date:2013-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ332B00000X, 332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ341246Medicaid
AZ341246Medicaid
AZZ102176Medicare PIN