Provider Demographics
NPI:1437152659
Name:PROSTHETICARE
Entity Type:Organization
Organization Name:PROSTHETICARE
Other - Org Name:PROSTHETIC CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:MARTHA
Authorized Official - Middle Name:L
Authorized Official - Last Name:STRUNCK
Authorized Official - Suffix:
Authorized Official - Credentials:CP
Authorized Official - Phone:717-764-8737
Mailing Address - Street 1:1590 RODNEY RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17404-9715
Mailing Address - Country:US
Mailing Address - Phone:717-764-8737
Mailing Address - Fax:717-764-3577
Practice Address - Street 1:1590 RODNEY RD
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17404-9715
Practice Address - Country:US
Practice Address - Phone:717-764-8737
Practice Address - Fax:717-764-3577
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0014542960002Medicaid
PA0613020001Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER