Organization
CENTRAL PA PROSTHETICS/ORTHOTICS, INC
Active
Parent organization
CENTRAL PA PROSTHETICS/ORTHOTICS, INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
CENTRAL PA PROSTHETICS/ORTHOTICS, INC
Authorized official
MR. HOWARD C STOUT CP (PRESIDENT/OWNER)
(570) 672-4580
Entity
Organization
Contact information
Practice address
173 S MARKET ST, ELYSBURG, PA 17824-9757
(570) 672-4580
(570) 672-4581
Mailing address
173 S MARKET ST, ELYSBURG, PA 17824-9757
(570) 672-4580
(570) 672-4581
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
PO000182
PA
335E00000X
Prosthetic/Orthotic Supplier
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0014697350002
—
PA
01
—
139892
GHP
PA
01
—
220529
HIGHMARK BLUE SHIELD
PA
01
—
2257250
AETNA
—
01
—
39HA89
BLUE CROSS
PA
Enumeration date
02/23/2006
Last updated
06/19/2017
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