Provider Demographics
NPI:1669651931
Name:THECODA PROSTHETICS,LLC
Entity Type:Organization
Organization Name:THECODA PROSTHETICS,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:THEODORE
Authorized Official - Middle Name:R
Authorized Official - Last Name:ARLOTTO
Authorized Official - Suffix:
Authorized Official - Credentials:MAMS
Authorized Official - Phone:440-289-6977
Mailing Address - Street 1:6315 PEARL RD STE 301B
Mailing Address - Street 2:
Mailing Address - City:PARMA HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44130-3074
Mailing Address - Country:US
Mailing Address - Phone:440-289-6977
Mailing Address - Fax:440-845-1805
Practice Address - Street 1:6315 PEARL RD STE 301B
Practice Address - Street 2:
Practice Address - City:PARMA HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44130-3074
Practice Address - Country:US
Practice Address - Phone:440-289-6977
Practice Address - Fax:440-244-2743
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-02
Last Update Date:2022-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0.29335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH5995920001Medicare NSC