Provider Demographics
NPI:1801289384
Name:HORIZON PROSTHETICS, LLC
Entity type:Organization
Organization Name:HORIZON PROSTHETICS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:MCKENNA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-660-1238
Mailing Address - Street 1:200 S WILCOX ST # 245
Mailing Address - Street 2:
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80104-1913
Mailing Address - Country:US
Mailing Address - Phone:303-660-1238
Mailing Address - Fax:
Practice Address - Street 1:9360 STATION ST STE 325
Practice Address - Street 2:
Practice Address - City:LONE TREE
Practice Address - State:CO
Practice Address - Zip Code:80124-6819
Practice Address - Country:US
Practice Address - Phone:303-660-1238
Practice Address - Fax:303-872-6528
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MCKENNA HOLDINGS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-03-09
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO20156000418335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier