Ohio Custom Orthotics LLC

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

Legal business name

OHIO CUSTOM ORTHOTICS LLC

Practice address

2621 Dryden Rd
Ste 106
Moraine, OH 45439-1661

Phone

(314) 821-2600

Fax

(888) 770-2935

NPI assigned

Mar 8, 2013

Organization subpart

No

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

Authorized official

Name

Don Havey

Title

Owner

Phone

(314) 821-2600

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1362700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1362700800000",
    "number": "1659612125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17600 CHESTERFIELD AIRPORT RD",
            "address_2": "STE. 204",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630051246",
            "telephone_number": "314-821-2600",
            "fax_number": "888-770-2935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2621 DRYDEN RD",
            "address_2": "STE 106",
            "city": "MORAINE",
            "state": "OH",
            "postal_code": "454391661",
            "telephone_number": "314-821-2600",
            "fax_number": "888-770-2935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OHIO CUSTOM ORTHOTICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-08",
        "last_updated": "2013-03-08",
        "status": "A",
        "authorized_official_last_name": "HAVEY",
        "authorized_official_first_name": "DON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "314-821-2600"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Customized Equipment (DME) in Moraine, OH
• Providers in Moraine, OH by specialty
• Customized Equipment (DME) in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2013; 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.