Organization
QUAD CITY PROSTHETIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. AMIT BHANTI CPO (CEO)
(309) 676-2276
Entity
Organization
Contact information
Practice address
4730 44TH ST, ROCK ISLAND, IL 61201
(309) 283-0880
(309) 283-0881
Mailing address
741 W MAIN ST, PEORIA, IL 61606-1953
(800) 334-5705
(888) 663-6322
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0008170232
BLUE CROSS BLUE SHIELD
IL
05
—
0933150
—
IA
01
—
131131100
US DEPT OF LABOR
—
05
—
41788300
—
WI
01
—
44119
WELLMARK BLUE CROSS
IA
05
—
623820305
—
MO
Enumeration date
10/09/2005
Last updated
09/24/2024
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