Provider Demographics
NPI:1467459719
Name:FAITH PROSTHETIC-ORTHOTIC SERVICES INC.
Entity Type:Organization
Organization Name:FAITH PROSTHETIC-ORTHOTIC SERVICES INC.
Other - Org Name:HANGER CLINIC
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR OF REIMBURSEMENT
Authorized Official - Prefix:
Authorized Official - First Name:SHERYL
Authorized Official - Middle Name:S
Authorized Official - Last Name:PRICE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-493-8288
Mailing Address - Street 1:PO BOX 650846
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75265-0846
Mailing Address - Country:US
Mailing Address - Phone:704-334-1860
Mailing Address - Fax:704-347-2785
Practice Address - Street 1:2001 E 7TH ST STE I
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28204-3311
Practice Address - Country:US
Practice Address - Phone:704-334-1860
Practice Address - Fax:704-347-2785
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HANGER, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-07-01
Last Update Date:2014-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7700566Medicaid
0141350005Medicare NSC