Provider Demographics
NPI:1851340251
Name:ARIZONA PROSTHETIC ORTHOTIC SERVICES LLC
Entity Type:Organization
Organization Name:ARIZONA PROSTHETIC ORTHOTIC SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRACTIONER
Authorized Official - Prefix:MR
Authorized Official - First Name:RON
Authorized Official - Middle Name:
Authorized Official - Last Name:GOLDSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:CPO,FAAOP
Authorized Official - Phone:602-485-8400
Mailing Address - Street 1:PO BOX 27215
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-0136
Mailing Address - Country:US
Mailing Address - Phone:602-448-3039
Mailing Address - Fax:
Practice Address - Street 1:4955 E BELL RD
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-6004
Practice Address - Country:US
Practice Address - Phone:602-485-8400
Practice Address - Fax:602-485-8401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-10
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ1200510001Medicare NSC