# MERCADO ORTHOTICS & PROSTHETICS

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114507290
- **Authorized official:** MRS. AUDREY EDITH MOORE (OWNER)
- **Authorized official phone:** (413) 923-7233

## Contact information

- **Practice address:** 399 FARMINGTON AVE, SUITE LL1, FARMINGTON, CT 06032-1937
- **Practice address phone:** (833) 888-0057
- **Practice address fax:** (413) 750-9916
- **Mailing address:** PO BOX 15108, SPRINGFIELD, MA 01115-5108
- **Mailing address phone:** (413) 923-7233
- **Mailing address fax:** (413) 750-9916

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |
| 335E00000X | Prosthetic/Orthotic Supplier | — | NULL | Yes |

## Other

- **Enumeration date:** 04/12/2021
- **Last updated:** 01/25/2022