Provider Demographics
NPI:1376897462
Name:FERRACO, INC.
Entity Type:Organization
Organization Name:FERRACO, INC.
Other - Org Name:HUMAN DESIGNS PROSTHETICS AND ORTHOTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:CRONIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-445-7797
Mailing Address - Street 1:2933 LONG BEACH BLVD
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90806-1517
Mailing Address - Country:US
Mailing Address - Phone:562-988-2414
Mailing Address - Fax:
Practice Address - Street 1:8734 CLETA ST
Practice Address - Street 2:UNIT C
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90241-5279
Practice Address - Country:US
Practice Address - Phone:562-869-1737
Practice Address - Fax:562-490-2833
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FERRACO, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-10-29
Last Update Date:2021-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACPO01294335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAXB0016930Medicaid
CAXB0016930Medicaid