Provider Demographics
NPI:1639332083
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:MS
Authorized Official - First Name:KERRIANN
Authorized Official - Middle Name:
Authorized Official - Last Name:CATLAW
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:603-668-6688
Mailing Address - Street 1:166 S RIVER RD
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:BEDFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03110-6928
Mailing Address - Country:US
Mailing Address - Phone:603-644-0774
Mailing Address - Fax:603-644-0776
Practice Address - Street 1:166 S RIVER RD
Practice Address - Street 2:2ND FLOOR
Practice Address - City:BEDFORD
Practice Address - State:NH
Practice Address - Zip Code:03110-6928
Practice Address - Country:US
Practice Address - Phone:603-644-0774
Practice Address - Fax:603-644-0776
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-07
Last Update Date:2009-08-30
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
NH5467630003Medicare NSC