Organization
GREEN PROSTHETICS & ORTHOTICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RAKESH JAIN (CEO)
(201) 774-1085
Entity
Organization
Contact information
Practice address
279 NORTH ST, MEADVILLE, PA 16335-2521
(814) 337-1159
(814) 337-7710
Mailing address
279 NORTH ST, MEADVILLE, PA 16335-2521
(814) 337-1159
(814) 337-7710
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
332BC3200X
Customized Equipment (DME)
—
—
335E00000X
Prosthetic/Orthotic Supplier
6000005987
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02254635
—
NY
05
—
0322029
—
OH
05
—
1007721900003
—
PA
Enumeration date
06/15/2006
Last updated
04/26/2024
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