Provider Demographics
NPI:1649437872
Name:COSHOCTON COUNTY FOOT & ANKLE CENTER, INC
Entity type:Organization
Organization Name:COSHOCTON COUNTY FOOT & ANKLE CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:LITSEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-622-0338
Mailing Address - Street 1:1100 FAIRY FALLS DR
Mailing Address - Street 2:SUITE 5
Mailing Address - City:COSHOCTON
Mailing Address - State:OH
Mailing Address - Zip Code:43812-2803
Mailing Address - Country:US
Mailing Address - Phone:740-622-0338
Mailing Address - Fax:888-730-2212
Practice Address - Street 1:1100 FAIRY FALLS DR
Practice Address - Street 2:SUITE 5
Practice Address - City:COSHOCTON
Practice Address - State:OH
Practice Address - Zip Code:43812-2803
Practice Address - Country:US
Practice Address - Phone:740-622-0338
Practice Address - Fax:888-730-2212
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-16
Last Update Date:2019-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2656335E00000X, 332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2832582Medicaid
OH9375471Medicare PIN
OH2832582Medicaid
OH6134090001Medicare NSC