Glacier Prosthetic Care, Inc.

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

GLACIER PROSTHETIC CARE, INC.

Practice address

1110 W Park PL
Suite 202
Coeur D Alene, ID 83814-2781

Phone

(208) 667-3344

Fax

(208) 667-2745

NPI assigned

Jun 4, 2010

Last updated

Sep 15, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Gina Carpenter

Title

Vice President

Phone

(406) 755-3344

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1275609600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1284508800000",
    "number": "1780904474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "985 N MERIDIAN RD",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599013539",
            "telephone_number": "406-755-3344",
            "fax_number": "406-755-2746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 W PARK PL",
            "address_2": "SUITE 202",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142781",
            "telephone_number": "208-667-3344",
            "fax_number": "208-667-2745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLACIER PROSTHETIC CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-04",
        "last_updated": "2010-09-15",
        "status": "A",
        "authorized_official_last_name": "CARPENTER",
        "authorized_official_first_name": "GINA",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "406-755-3344"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kirandeep K Gill, D.O.
• Ryan John Gilles, MD
• Erin Gilliland
• Scott Anthony Gittens, LMSW
• Jenny Marie Gjoraas, LMSW
• Gary B Glenn, CRNA
• Garrett Glover
• Kevin Glover
• Taylor Glovsky
• Stephen Godfrey

• Prosthetic/Orthotic Supplier in Coeur d'Alene, ID
• Providers in Coeur d'Alene, ID by specialty
• Prosthetic/Orthotic Supplier in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 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.