Provider Demographics
NPI:1710945985
Name:ADAPTEC PROSTHETICS, LLC
Entity Type:Organization
Organization Name:ADAPTEC PROSTHETICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROYCE
Authorized Official - Middle Name:KENT
Authorized Official - Last Name:HECK
Authorized Official - Suffix:
Authorized Official - Credentials:CPO
Authorized Official - Phone:720-344-1212
Mailing Address - Street 1:1501 W CAMPUS DR STE K
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80120-4535
Mailing Address - Country:US
Mailing Address - Phone:720-344-1212
Mailing Address - Fax:720-344-1219
Practice Address - Street 1:1501 W CAMPUS DR STE K
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80120-4535
Practice Address - Country:US
Practice Address - Phone:720-344-1212
Practice Address - Fax:720-344-1219
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-03
Last Update Date:2022-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO63357330Medicaid
CO5556970001Medicare NSC