Provider Demographics
NPI:1952536856
Name:CENTRAL PROSTHETICS & ORTHOTICS, INC
Entity type:Organization
Organization Name:CENTRAL PROSTHETICS & ORTHOTICS, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ED
Authorized Official - Middle Name:H
Authorized Official - Last Name:GILDEHAUS
Authorized Official - Suffix:
Authorized Official - Credentials:CPO, FAAOP, CPED
Authorized Official - Phone:859-263-7712
Mailing Address - Street 1:1555 E NEW CIRCLE RD STE 142
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40509-1044
Mailing Address - Country:US
Mailing Address - Phone:859-263-7712
Mailing Address - Fax:859-263-7607
Practice Address - Street 1:3295 EAGLE VIEW LN
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509
Practice Address - Country:US
Practice Address - Phone:859-263-7712
Practice Address - Fax:859-263-7607
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CENTRAL PROSTHETICS & ORTHOTICS, INC. DBA: CENTR
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-05-20
Last Update Date:2022-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier