Provider Demographics
NPI:1720395528
Name:ORTHOTEK, INC
Entity Type:Organization
Organization Name:ORTHOTEK, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:STEENHOEK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-255-0952
Mailing Address - Street 1:9379 SWANSON BLVD
Mailing Address - Street 2:SUITE C
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50325-6942
Mailing Address - Country:US
Mailing Address - Phone:515-255-0952
Mailing Address - Fax:515-255-1617
Practice Address - Street 1:1211 APPLEWOOD DR
Practice Address - Street 2:SUITE 2
Practice Address - City:PAPILLION
Practice Address - State:NE
Practice Address - Zip Code:68046-5829
Practice Address - Country:US
Practice Address - Phone:402-933-0600
Practice Address - Fax:402-614-8341
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-01
Last Update Date:2012-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA5101640001Medicare NSC