Organization
MERCADO ORTHOTICS & PROSTHETICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. AUDREY EDITH MOORE (OWNER)
(413) 923-7233
Entity
Organization
Contact information
Practice address
399 FARMINGTON AVE, SUITE LL1, FARMINGTON, CT 06032-1937
(833) 888-0057
(413) 750-9916
Mailing address
PO BOX 15108, SPRINGFIELD, MA 01115-5108
(413) 923-7233
(413) 750-9916
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
04/12/2021
Last updated
01/25/2022
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