Provider Demographics
NPI:1518122274
Name:ORTHOPEDIC REHAB, INC.
Entity Type:Organization
Organization Name:ORTHOPEDIC REHAB, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE ASSISTANT
Authorized Official - Prefix:MRS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:A
Authorized Official - Last Name:HARDCASTLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-948-0134
Mailing Address - Street 1:5066 S. WADSWORTH WAY
Mailing Address - Street 2:STE 128
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80123
Mailing Address - Country:US
Mailing Address - Phone:303-948-0134
Mailing Address - Fax:303-948-2991
Practice Address - Street 1:5066 S. WADSWORTH WAY
Practice Address - Street 2:STE 128
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80123
Practice Address - Country:US
Practice Address - Phone:303-948-0134
Practice Address - Fax:303-948-2991
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-22
Last Update Date:2008-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCO000969335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO0306200001Medicare NSC