Provider Demographics
NPI:1962685842
Name:ASCENT ORTHOTICS AND PROSTHETICS, INC.
Entity Type:Organization
Organization Name:ASCENT ORTHOTICS AND PROSTHETICS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:N
Authorized Official - Last Name:HENDRICKSON
Authorized Official - Suffix:
Authorized Official - Credentials:CP
Authorized Official - Phone:303-316-2615
Mailing Address - Street 1:1633 FILLMORE ST
Mailing Address - Street 2:GL5
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80206-1514
Mailing Address - Country:US
Mailing Address - Phone:303-316-2615
Mailing Address - Fax:
Practice Address - Street 1:1633 FILLMORE ST
Practice Address - Street 2:GL5
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80206-1514
Practice Address - Country:US
Practice Address - Phone:303-316-2615
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-13
Last Update Date:2008-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO98928783Medicaid
CO6053300001Medicare NSC