Provider Demographics
NPI:1710521851
Name:HALLEY ORTHOPEDIC PRODUCTS LLC
Entity Type:Organization
Organization Name:HALLEY ORTHOPEDIC PRODUCTS LLC
Other - Org Name:X10 HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:855-447-7763
Mailing Address - Street 1:21238 BRIDGE ST STE A
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48033-4089
Mailing Address - Country:US
Mailing Address - Phone:855-447-7763
Mailing Address - Fax:
Practice Address - Street 1:21238 BRIDGE ST STE A
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48033-4089
Practice Address - Country:US
Practice Address - Phone:855-447-7763
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-01
Last Update Date:2021-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health