Provider Demographics
NPI:1477593895
Name:BARNHART PROSTHETIC AND ORTHOTIC SERVICES INC
Entity Type:Organization
Organization Name:BARNHART PROSTHETIC AND ORTHOTIC SERVICES INC
Other - Org Name:BARNHART PROSTHETICS AND ORTHODIC SERVICES LLC NATHAN KEEPERS LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:NATHAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:KEEPERS
Authorized Official - Suffix:
Authorized Official - Credentials:CPO
Authorized Official - Phone:541-485-5929
Mailing Address - Street 1:1881 2ND STREET
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OR
Mailing Address - Zip Code:97477
Mailing Address - Country:US
Mailing Address - Phone:541-485-5929
Mailing Address - Fax:541-485-3955
Practice Address - Street 1:1881 2ND STREET
Practice Address - Street 2:SUITE 101
Practice Address - City:SPRINGFIELD
Practice Address - State:OR
Practice Address - Zip Code:97477
Practice Address - Country:US
Practice Address - Phone:541-485-5929
Practice Address - Fax:541-485-3955
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-07
Last Update Date:2014-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR009237000OtherREGENCE BLUE CROSS
OR015404Medicaid
5611310001Medicare NSC