Provider Demographics
NPI:1538134135
Name:BENCHMARK ORTHOTICS-PROSTHETICS, INC.
Entity Type:Organization
Organization Name:BENCHMARK ORTHOTICS-PROSTHETICS, INC.
Other - Org Name:BENCHMARK ORTHOTICS-PROSTHETICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESDIENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:J
Authorized Official - Last Name:FITZPATRICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-644-7824
Mailing Address - Street 1:5100 LIBERTY AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15224-2218
Mailing Address - Country:US
Mailing Address - Phone:412-687-5347
Mailing Address - Fax:412-687-1869
Practice Address - Street 1:5100 LIBERTY AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15224-2218
Practice Address - Country:US
Practice Address - Phone:412-687-5347
Practice Address - Fax:412-687-1869
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA6000005838335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA4318080028Medicare ID - Type UnspecifiedMEDICARE PROVIDER#