Provider Demographics
NPI:1467563189
Name:ORTHOCARE MEDICAL EQUIPMENT, LLC
Entity Type:Organization
Organization Name:ORTHOCARE MEDICAL EQUIPMENT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:KERRIANN
Authorized Official - Middle Name:
Authorized Official - Last Name:CATLAW
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, ATC, CFO
Authorized Official - Phone:603-668-6688
Mailing Address - Street 1:700 LAKE AVE
Mailing Address - Street 2:SUITE 6
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03103-2734
Mailing Address - Country:US
Mailing Address - Phone:603-668-6688
Mailing Address - Fax:603-668-6689
Practice Address - Street 1:700 LAKE AVE
Practice Address - Street 2:SUITE 6
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03103-2734
Practice Address - Country:US
Practice Address - Phone:603-668-6688
Practice Address - Fax:603-668-6689
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2012-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH03125332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30763824Medicaid
NH30763824Medicaid