Provider Demographics
NPI:1750455614
Name:HANGER PROSTHETICS & ORTHOTICS EAST INC
Entity Type:Organization
Organization Name:HANGER PROSTHETICS & ORTHOTICS EAST INC
Other - Org Name:HANGER CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIR OF REIMBURSEMENT
Authorized Official - Prefix:
Authorized Official - First Name:SHERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:PRICE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-493-8288
Mailing Address - Street 1:8626 WICKER AVE STE C
Mailing Address - Street 2:
Mailing Address - City:SAINT JOHN
Mailing Address - State:IN
Mailing Address - Zip Code:46373-9053
Mailing Address - Country:US
Mailing Address - Phone:219-365-1424
Mailing Address - Fax:
Practice Address - Street 1:8626 WICKER AVE STE C
Practice Address - Street 2:SUITE C
Practice Address - City:SAINT JOHN
Practice Address - State:IN
Practice Address - Zip Code:46373-9053
Practice Address - Country:US
Practice Address - Phone:219-365-1424
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HANGER INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-11-20
Last Update Date:2015-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200269590AMedicaid
IN200269590AMedicaid