Provider Demographics
NPI:1013990068
Name:OGDEN ORTHOTICS & PROSTHETICS, INC.
Entity Type:Organization
Organization Name:OGDEN ORTHOTICS & PROSTHETICS, INC.
Other - Org Name:HANGER CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF REIMBURSEMENT
Authorized Official - Prefix:MS
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:PO BOX 650846
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75265-0846
Mailing Address - Country:US
Mailing Address - Phone:801-392-5999
Mailing Address - Fax:801-392-1888
Practice Address - Street 1:3585 HARRISON BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84403-2039
Practice Address - Country:US
Practice Address - Phone:801-392-5999
Practice Address - Fax:801-392-1888
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HANGER INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-11-23
Last Update Date:2014-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT103001239101OtherIHC
UT190231400OtherFEDERAL WORKER COMP
UT82007OtherUNITED HEALTH CARE
WY1125-4400OtherWYOMING MEDICAID
WY1125-4400OtherWYOMING MEDICAID
UT=========005Medicaid
UT190231400OtherFEDERAL WORKER COMP
UT=========005Medicaid