Orthotic & Prosthetic Lab Inc

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

Legal business name

ORTHOTIC & PROSTHETIC LAB INC

Practice address

125 N Weinbach Ave
Suite 310
Evansville, IN 47711-6091

Phone

(812) 479-6298

Fax

(812) 479-6758

NPI assigned

Jan 8, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Cynthia Kaye Allen

Title

Office Manager

Phone

(812) 479-6298

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1265241600000",
    "number": "1154479798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 N WEINBACH AVE",
            "address_2": "SUITE 310",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477116091",
            "telephone_number": "812-479-6298",
            "fax_number": "812-479-6758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 N WEINBACH AVE",
            "address_2": "SUITE 310",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477116091",
            "telephone_number": "812-479-6298",
            "fax_number": "812-479-6758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHOTIC & PROSTHETIC LAB INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-08",
        "last_updated": "2010-02-04",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_middle_name": "KAYE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "812-479-6298",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100179970A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Customized Equipment (DME) in Evansville, IN
• Providers in Evansville, IN by specialty
• Customized Equipment (DME) in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.