Provider Demographics
NPI:1811198179
Name:ORTHOPAEDIC SPECIALTIES, INC.
Entity Type:Organization
Organization Name:ORTHOPAEDIC SPECIALTIES, INC.
Other - Org Name:ORTHOPAEDIC SPECIALTIES OF LEXINGTON, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:NOLAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-268-2525
Mailing Address - Street 1:812 RED LEAF CT
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40509-1759
Mailing Address - Country:US
Mailing Address - Phone:859-268-2525
Mailing Address - Fax:859-268-2255
Practice Address - Street 1:2216 YOUNG DR
Practice Address - Street 2:SUITE 4
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40505-4220
Practice Address - Country:US
Practice Address - Phone:859-268-2525
Practice Address - Fax:859-268-2255
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-31
Last Update Date:2020-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY90950346Medicaid
KY45903176Medicaid
KY0771740002Medicare NSC