Provider Demographics
NPI:1659832202
Name:CAPITOL ORTHOPEDIC INC
Entity Type:Organization
Organization Name:CAPITOL ORTHOPEDIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:ADAME
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-369-8734
Mailing Address - Street 1:1701 COMMERCE RD
Mailing Address - Street 2:
Mailing Address - City:TONGANOXIE
Mailing Address - State:KS
Mailing Address - Zip Code:66086-5369
Mailing Address - Country:US
Mailing Address - Phone:913-369-8734
Mailing Address - Fax:844-409-6687
Practice Address - Street 1:1702 W ANKLAM RD STE 111
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85745-2606
Practice Address - Country:US
Practice Address - Phone:913-369-8734
Practice Address - Fax:844-409-6687
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CAPITOL ORTHOPEDIC INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-03-27
Last Update Date:2019-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier